Remote CA Appeals & Grievances Specialist
Kforce Inc
- Remote job
Kforce Inc is hiring a Customer Support Specialist for a remote role based in California. This role focuses on appeals and grievances management, requiring the specialist to ensure positive outcomes for members. Responsibilities include investigating and resolving complaints while adhering to regulatory standards. Candidates should have a High School diploma or equivalent, preferably an Associate's degree, and at least 1 year of experience in Managed Care. Key skills include excellent communication, analytical abilities, and competency in MS Office applications. #J-18808-Ljbffr Kforce Inc
- ...L.A. Care Health Plan is seeking an Appeals and Grievances Specialist II in Los Angeles, CA. The role involves investigating member and provider complaints, ensuring compliance with various health regulations, and preparing reports. Requirements include at least 2 years...Remote workFull time
$60.78k
Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13061 Salary Range: $60,778.0... ...after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/...Remote workFull timeLocal areaShift workWeekend work$14.9 - $29.06 per hour
...(CMS). Responsibilities Enters denials and requests for appeals into information system and prepares documentation for further... ...language for letters and prepares responses to member appeals and grievances. Elevates appropriate appeals to the next level for review....Remote workHourly payWork experience placementWork at officeWeekend work$21.16 - $38.37 per hour
...Join to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina Healthcare . This position is remote and will be working Pacific Standard hours. Highly Qualified Candidates Will Have The Following Experience Strong understanding of...Remote workHourly payFull timeContract workWork experience placementWork at office- KYYBA Inc is seeking a Grievance & Appeals Coordinator to join their team remotely. This role involves processing appeals and grievances while adhering to regulatory guidelines. Ideal candidates will possess a minimum of two years in customer service and health insurance...Remote job
- ...employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the... ...resolving and responding to requests for member and provider appeals, grievances, reconsiderations and corrected claims for all lines of business...Remote workFull timeContract workWork experience placementWork at officeLocal area1 day per week
- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote job
$248.5k - $373k
...Appeals And Grievances Medical Director At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities... ...associated companies. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough...Remote jobMinimum wageWork experience placementLocal areaWork from home$50k - $55k
.... Under the direction of the Appeals Department leaders, the Appeals... ...the department. The Appeals Specialist level II performs research,... ...investigation, and analysis of appeals, grievances, and other types of... ...frequent interruptions Remote Work Requirements High speed...Remote work- ...Member And Provider Complaint Resolution Specialist 100% remote candidates must live in one of the preferred 15 states (AZ, FL, GA... ...for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from Molina members, providers and...Remote workContract workLive inMonday to Friday
$21.16 - $38.37 per hour
A healthcare provider is seeking a Medicare Appeals & Grievances Specialist to handle member appeals and grievances. This remote position requires strong experience in managed care, particularly with Medicare regulations. Ideal candidates will have excellent attention...Remote jobHourly payWork at office$38.11 - $50.23 per hour
Title: Child Life Specialist I-Part Time (Limited) Location: Los Angeles, CA, USA Work Schedule: Monday through Thursday... ...that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. #J-18808-Ljbffr RemoteRemote workHourly payPart timeInternshipMonday to Thursday$45.9k - $78.6k
...community of connected care, where coordinated, quality service is the norm and every member feels valued. Medica's Appeals and Grievance Specialist plays a vital role in ensuring our members and providers receive clear, timely, and accurate resolutions to their...Work experience placementWork at office3 days per week- ...Commercial Appeals and Grievance Registered Nurse (RN) The Commercial Appeals and Grievance RN reviews and processes member-generated pre-service and post-service appeals and grievances. This role is responsible for concurrent review of medical records and documentation...Work at officeLocal area
- ..., member and provider complaints, and reconsideration and redetermination requests. Review and respond to complaints, grievances and appeals within the stated time frame for each request Certify that providers and members are reimbursed accordingly using Medicare...
$19 - $20 per hour
...Position: Grievance & Appeals Specialist Compensation: $19-$20 /hour, depending on experience Location: Tulsa, Oklahoma Inceed has partnered with a great company to help find a skilled Grievance & Appeals Specialist to join their team! Step into a dynamic...Weekly payPermanent employmentWork at officeMonday to Friday$18.33 per hour
...Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $18.33 Maximum Offer $27.25 Now Hiring: Appeals and Grievance Specialist Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled Appeals and Grievance Specialist...Full timeTemporary workLocal areaImmediate startShift work$24 - $24.5 per hour
Fallon Health in Worcester, MA is hiring a Healthcare Triage Administrator. This position supports the Appeals and Grievances process, handling member and provider interactions while ensuring compliance with regulatory standards. The ideal candidate will have a high school...Hourly pay$45.9k - $68.78k
Medica Services Company LLC in Minnetonka is looking for an Appeals and Grievance Specialist to manage member concerns and ensure timely resolutions. The role requires a high school diploma, strong analytical skills, and up to 5 years of experience in healthcare operations...3 days per week$45 - $50 per hour
...a reality! About the Role As a Mech Specialist, you will be the primary engineer to operate... ...training will be onsite in Redwood City, CA prior to working at client site***... ...they can travel on a weekly basis to each remote location. This position requires extended...Remote workLocal areaFlexible hours- ...Position: Business Analyst III - Appeals & Grievances Location: Los Angeles, CA, US (Remote) Duration: Permanent Job Description: The Business Analyst III facilitates business process improvement via the methodical investigation, analysis, review...Remote workPermanent employmentWork at office
- ...A healthcare company is seeking a skilled Appeals Processor III to work remotely in the United States. This role involves reviewing and processing healthcare appeals related to Medicaid or Medicare coverage decisions. The ideal candidate will have at least 2 years of...Remote work
- ...Dept: MA Grievances and Appea Will this position be required to work onsite... ...reason at any time? No, fully remote avoid submitting candidates from... ...FL, AZ, NY, NJ, MO, MA, MD, and CA Engagement Description - Process appeals and grievances, analyze, research...Remote workContract work
- Blue Cross Blue Shield of Arizona seeks a Clinical Appeals Specialist to utilize their clinical acumen for resolving member and provider appeals, grievances, and claims. The role requires a minimum of 1 year of healthcare-related experience and an Associate's Degree in...
- ...A-Line Staffing is hiring a Grievance & Appeals Coordinator in the Natomas or Woodland Hills, CA area. This is Full-Time 40 hours per week with a Major Healthcare Company... ...Must be local to Natomas or Woodland Hills, CA Remote but may need to travel to the Centene office for...Remote workBi-weekly payFull timeContract workWork at officeLocal areaImmediate startMonday to Friday
$30 - $32 per hour
...Immediate need for a talented Appeals & Grievance Manager. This is a 12 months contract opportunity with long-term potential and is located in Corona, CA(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID: 26-1716...Remote workContract workLocal areaImmediate start- A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage... ...processing, and excellent analytical and communication skills. Remote work options are available along with competitive benefits...Remote work
- ...Position Title EVEL 7 - Opcenter MES Specialist Work Location Fremont, CA, US (Hybrid) Travel Requirement 20-25% (4-5 days per month; travel and expenses... ...Semiconductor or Medical Work Arrangement Hybrid: Remote work with monthly office presence in Fremont, CA. #J-188...Remote workWork at office
$74.8k - $78.7k
...Carolina); Omaha, NE (Nebraska); Work from Home Work Arrangement: Remote : Work at home employee residing outside of a commutable... ...opportunity. Requisition #: 76084 The Role at a Glance As an Appeals Specialist you will be responsible for being a product subject matter expert...Remote workContract workTemporary workWork experience placementWork at officeWork from homeRelocation package- ...Job Posting Title Review & Appeals Specialist I Applicants must be authorized to work... ...employees in hybrid positions work both remotely and onsite in the NCCPA headquarters based... ...in business, healthcare, appeals and grievances, state medical board, legal, or...Remote workWork at office
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