Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Pharmacist Appeals Specialist

Texas Health Institute

Houston, TX
  • 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

Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote Pharmacist Appeals Specialist in Houston, TX vacancy
  •  ...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 work
    Work from home

    Pharmacy Careers

    United States
    2 days ago
  • 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

    Global Channel Management

    Chattanooga, TN
    20 hours ago
  • 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 job
    Work from home

    Pharmacy Careers

    Arlington, VA
    2 days ago
  • 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 job
    Work from home

    Pharmacy Careers

    Seattle, WA
    2 days ago
  • 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 job
    Work from home

    Pharmacy Careers

    Kansas City, MO
    2 days ago
  • 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

    Pharmacy Careers

    Newark, NJ
    2 days ago
  • 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

    Wapa

    Houston, TX
    1 day ago
  •  ...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 work
    Internship

    Prisma Health

    Columbia, SC
    2 days ago
  • $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 job
    Hourly pay
    Work experience placement

    Phenom People

    Minnetonka, MN
    3 days ago
  • 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 job
    Flexible hours

    Stryker Corporation

    Sugar Land, TX
    2 days ago
  •  ...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 work
    Contract work

    Virtual Vocations Inc

    United States
    3 days ago
  •  ...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

    RAIL-WAY INC

    New York, NY
    3 days ago
  •  ...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 work
    Full time

    Virtual Vocations Inc

    United States
    4 days ago
  •  ...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 job
    Full time
    Work from home

    Moda Health

    Portland, OR
    4 days ago
  •  ...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 work
    Contract work
    Work at office

    Virtual Vocations Inc

    United States
    1 day ago
  •  ...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 work
    Traineeship

    Saviance

    United States
    4 days ago
  •  ...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 work
    Contract work

    Saviance

    United States
    5 hours ago
  • $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 work
    Hourly pay

    Quadax

    Cleveland, OH
    1 day ago
  • $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 work
    Temporary work
    Work at office
    Local area

    Ensemble Health Partners

    United States
    1 day ago
  • $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 work
    Full time
    Local area
    Shift work
    Weekend work

    LOS Angeles Care Health Plan

    Los Angeles, CA
    20 hours ago
  • $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 work
    Hourly pay
    Full time
    Contract work
    Work experience placement
    Work at office

    Molina Healthcare

    Phoenix, AZ
    3 days ago
  • $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 work
    Work at office
    Monday to Friday

    Trillium Staffing

    United States
    7 hours ago
  • 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

    Cognizant

    Phoenix, AZ
    2 days ago
  • 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

    Aspirion

    Delray Beach, FL
    4 days ago
  • $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 job
    Hourly pay

    CERIS

    Fort Worth, TX
    2 days ago
  • $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 work
    Temporary work
    Work at office
    Local area

    Ensemble Health Partners

    Brooklyn, NY
    4 days ago
  • 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

    Aspirion Health Resources, LLC

    Delray Beach, FL
    1 day ago
  • 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 job
    Full time

    L.A. Care Health Plan

    Los Angeles, CA
    1 day ago
  • 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 job
    Part time
    Monday to Friday
    Shift work

    Banner Health

    Phoenix, AZ
    2 days ago
  • 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 job
    2 days per week

    Christiana Care Health System

    Newark, DE
    20 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Pharmacist Appeals Specialist. Be the first to apply!