Remote Pharmacist Appeals Specialist
Texas Health Institute
- Remote job
UnitedHealth Group is seeking an experienced Pharmacist to evaluate prescriptions and patient histories, interpret clinical documents, and render prior authorization decisions. You will consult with patients and providers on medication use, coverages, and potential drug interactions, while ensuring accurate documentation and compliance. The role offers telecommuting from anywhere in the U.S. with competitive hourly pay and benefits. #J-18808-Ljbffr Texas Health Institute
- ...Remote Appeals Pharmacist - Fair Medication Access | Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy in a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based guidelines, and ensure fair...Remote workWork from home
- A healthcare management company is seeking a Remote Coverage Review Pharmacist located in Tennessee. This role requires a Doctor of Pharmacy (PharmD... ...responsible for reviewing medication-related prior authorizations, appeals, and grievances, working independently or in a team to...Remote work
- Pharmacy Careers is seeking a Remote Appeals Pharmacist to ensure fair access to medications. You will review clinical documentation for coverage appeals from home and provide evidence-based determinations. This role supports managed care through strong documentation, clinical...Remote jobWork from home
- Pharmacy Careers is seeking a fully remote Appeals Pharmacist to review medication coverage appeals and provide evidence-based determinations from home. A focus on clear clinical writing and regulatory compliance helps ensure fair access for members. The role supports remote...Remote jobWork from home
- Pharmacy Careers is seeking a Remote Appeals Pharmacist to review medication coverage appeals from home, applying evidence-based guidelines and regulatory requirements to reach fair determinations. This role emphasizes strong clinical writing and collaboration with physicians...Remote jobWork from home
- Pharmacy Careers is seeking a Remote Appeals Pharmacist focused on fair medication access. This fully remote or hybrid role involves reviewing medication coverage appeals, applying evidence-based guidelines, and writing clear clinical rationales for determinations. You...Remote job
- UnitedHealth Group is seeking a pharmacist to evaluate prescriptions, assess patient histories, and render timely PA decisions. The role supports appeals, requires strong clinical knowledge, and offers telecommuting from anywhere in the United States. The position emphasizes...Remote job
- ...pharmacy executives, directors, functional managers, and clinical pharmacists on a regular basis as well as non-pharmacy clinical, ancillary... ..., weaknesses, opportunities, and risks. This position allows remote work at the discretion of the reporting operational leader....Remote workInternship
$40.87 - $80.43 per hour
...Pharmacist At UnitedHealthcare, we're simplifying the health care experience, creating... ...You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take... ...drug interactions, and clinical status for appeals requests Conduct Quality Assurance and...Remote jobHourly payWork experience placement- UnitedHealth Group is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals across multiple channels... ...ability to work flexible shifts. You will collaborate with pharmacists and clinicians to resolve complex requests while adhering to...Remote jobFlexible hours
- ...Managing member appeal cases remotely, the contract Member Appeals Specialist will ensure accuracy, compliance, and timely resolution while coordinating incoming appeals and collaborating with cross-functional teams in a highly regulated healthcare environment. Key responsibilities...Remote workContract work
- ...St. Luke's in the United States is seeking a Denials Management Specialist to join our remote team. This role focuses on inpatient CMS denials, medical necessity reviews, and appeals for insurance payers. You will collaborate with Case Management and Billing to improve...Remote work
- ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints...Remote workFull time
- ...Health is seeking a motivated professional to investigate and respond to medical, pharmacy and dental grievances, complaints, and appeals. This is a full-time work-from-home position within Government Programs. Responsibilities include thorough case review, timely written...Remote jobFull timeWork from home
- ...Detail-oriented and analytical, the remote Billing & Appeals Specialist will manage provider billing disputes and appeals, ensuring accurate resolutions while maintaining exceptional customer service in a contract role. Key responsibilities Review, investigate, and resolve...Remote workContract workWork at office
- ...Member Appeals Specialist Primary responsibilities would include triaging incoming appeals/grievances, categorizing them appropriately, assigning them to the team, making outbound calls when necessary. Also checking voicemails, responding to emails/voicemails. The...Remote workTraineeship
- ...Appeals And Grievances Specialist Will the position be 100% remote? Yes. Are there any specific location requirements? No. Are there any time zone requirements? Prefer eastern time zone. What are the must have requirements? Experience working in A&G, ability to prioritize...Remote workContract work
$19 - $21 per hour
...Overview: Respond to all assigned levels of denials by submitting appeal letters and required documentation to insurance companies within... ...plan and work with the patient to get the denial overturned. Remote: Although this position is listed as remote, the training period...Remote workHourly pay$29.7 - $31.8 per hour
...between $29.70 - $31.80 based on experience The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the... ...and improve patient and client experiences. ~ This is a remote position; however, candidates must be willing and able to...Remote workTemporary workWork at officeLocal area$60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...Remote workFull timeLocal areaShift workWeekend 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$24.79 per hour
...Member Appeals Specialist Trillium Professional is now seeking a Member Appeals Specialist for a 100% remote position! Candidates will work Monday-Friday, 40 hours/week for about 13 weeks. Pay rate is $24.79/hour. Member Appeals Specialist to manage member appeals...Remote workWork at officeMonday to Friday- Cognizant is seeking a Provider Appeals Specialist for a remote role in the United States. You will review, research, and resolve provider appeals related to claims payment, reimbursement disputes, and contractual issues, liaising with providers, payers, and internal teams...Remote job
- Aspirion is seeking a Denials Appeals Specialist to analyze denied claims, draft compelling appeal letters, and submit appeals per payer guidelines... ...documentation to support revenue integrity and cash flow. Remote US-based role with growth opportunities. #J-18808-Ljbffr...Remote job
$20.08 - $30.06 per hour
CERIS is hiring an Appeals Representative in Fort Worth, Texas. The role involves reviewing and addressing provider inquiries and appeals while ensuring compliance with relevant regulations. The successful candidate will have strong attention to detail, excellent communication...Remote jobHourly pay$29.7 - $31.8 per hour
...$31.80 based on experience Job Description The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the performance... ...and improve patient and client experiences. This is a remote position; however, candidates must be willing and able to...Remote workTemporary workWork at officeLocal area- Aspirion Health Resources, LLC is seeking a Denials Appeals Specialist to analyze denial reasons, draft persuasive appeal letters, and submit... ...flow and reduce aging accounts receivable. You will work in a remote US-based environment, collaborating with cross-functional...Remote job
- 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 jobFull time
- Banner Health seeks a remote Grievance & Appeals Coordinator in Arizona to support members and providers through the grievance, appeal, and claim-dispute process. This part-time role requires experience with AHCCCS, CMS regulations, and strong communication. You will manage...Remote jobPart timeMonday to FridayShift work
- ChristianaCare in Delaware is seeking a Clinical Pharmacist Specialist to provide oncology/hematology care in the ambulatory setting. This role... ...is embedded in the Specialty Pharmacy program and may work remotely up to two days per week, supporting guideline development,...Remote job2 days per week
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