Remote Medical Management & Appeals Specialist
First Choice Health
- Remote job
First Choice Health is looking for a Medical Management Specialist to join its dynamic, remote team. This non-clinical role involves providing essential administrative support in areas like case management and operational coverage, ensuring quality initiatives are maintained. The ideal candidate will have at least two years of experience in a healthcare environment and strong proficiency in Microsoft Office and Google Workspace. This full-time role operates Monday to Friday, 8 am to 5 pm Pacific Time. #J-18808-Ljbffr First Choice Health
- ...up actions as advised Research claim variances in hospital patient accounting systems (EPIC, Meditech, Cerner, Athena) Draft appeals to insurance carriers on denied or underpaid claims Review claim detail including coding, billing and insurance information for...Remote workPermanent employmentWork from homeFlexible hours
- ...Provider Complaint Resolution Specialist 100% remote candidates must live in one... ...and resolution of the appeals, dispute, grievances, and/or... ...outcomes. Requests and reviews medical records, notes, and/or... ...Min. 2 years operational managed care experience (call center...Remote workContract workLive inMonday to Friday
$74.8k - $78.7k
...from Home Work Arrangement: Remote : Work at home employee residing... ...The Role at a Glance As an Appeals Specialist you will be responsible for... .... You will analyze and manage a caseload of appeals claims... ...policies & procedures regarding medical terminology, duration,...Remote workContract workTemporary workWork experience placementWork at officeWork from homeRelocation package$14.9 - $29.06 per hour
...Responsibilities Enters denials and requests for appeals into information system and prepares... ...Molina guidelines. Requests and obtains medical records, notes, and/or detailed bills as... ...experience. Organizational and time management skills; ability to manage simultaneous...Remote jobHourly payWork experience placementWork at officeWeekend work$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 to...Remote jobHourly payWork at office$24 - $25 per hour
...AVA) is a physician practice management company in a high-growth mode. We handle medical billing for our clinical... ...looking to add a Revenue Cycle Appeals & Recovery Specialist to join our fast-paced and energetic... ...! This role is full time, remote with a base rate of $24 to $...Remote workHourly payFull timeLive inShift work- ...healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage appeals and complaints. The ideal candidate... ...excellent analytical and communication skills. Remote work options are available along with...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... ...reports. Requirements include at least 2 years in Managed Care, knowledge of medical terminology, and excellent communication skills....Remote jobFull time
- Aspirion in Delray Beach, Florida, is looking for a Denials Appeals Specialist to analyze and submit appeals for denied claims. The role supports... ...bachelor’s degree preferred. The position involves working remotely and understanding healthcare operations. #J-18808-Ljbffr...Remote job
$27.74 - $39.16 per hour
...Coding Denial And Appeals Specialist The Coding Denial and Appeals Specialist... ...and resolving clinical and medical-necessity denials for... ...and revenue cycle analyst and management to address denial trends and... ...Monday-Friday Business Hours Remote work setting, but must live...Remote workHourly payFull timeLive inMonday to FridayFlexible hoursShift work- A healthcare company is seeking a skilled Appeals Processor III to work remotely in the United States. This role involves reviewing and processing healthcare... ...least 2 years of experience in healthcare appeals or medical claims and a strong understanding of CMS guidelines....Remote job
- ...classified as hybrid, onsite or remote. While the majority of our... ...utilizing clinical acumen and managed care expertise related to... ...requests for member and provider appeals, grievances, reconsiderations... ..., Case Management and/or Medical Appeals and Grievance (MAG)...Remote workFull timeContract workWork experience placementWork at officeLocal area1 day per week
- ...Specialist, Appeals Claims As an Appeals Specialist you will be responsible for being a product... ...applying knowledge. You will analyze and manage a caseload of appeals claims. You will... ...policies & procedures regarding medical terminology, duration, functionality documentation...Remote workContract workTemporary workWork experience placementWork at office
$21.16 - $38.37 per hour
...to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina... ...Healthcare . This position is remote and will be working... ...outcomes. Requests and reviews medical records, notes, and/or... ...Qualifications At least 2 years of managed care experience in a call...Remote workHourly payFull timeContract workWork experience placementWork at office$60.78k
Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles, CA... ...Services (DHCS), Department of Managed Health Care (DMHC), Managed Risk Medical Insurance Board (MBMIB) and... ...weekends, holidays, a hybrid remote schedule, occasional flexibility...Remote workFull timeLocal areaShift workWeekend work- 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
- ...healthcare organization located in Farmington, Connecticut, is seeking a Medical-Denial Management Specialist. The role focuses on analyzing healthcare insurance claim denials, preparing appeals, and collaborating with billing staff to ensure reimbursement. Ideal candidates...
$18.65 - $19.9 per hour
...technology-enabled revenue cycle management solutions for health systems,... ...experience We are seeking a Medical Records/Health Information Management Specialist . Job Responsibilities:... ...24 Monster Top Workplace for Remote Work 2024 Great Place to Work...Remote workLocal area$61.5k - $136.1k
...personnel and all other entities involved in managing care. Identifies alternate treatment... ...similar clinical guidelines * Knowledge of medical management policies and procedures * Work... ...in that Time Zone (CST). #LI-FW1 #LI-Remote This is a Remote/Work-From-Home role. Must...Remote workTemporary workLocal areaImmediate startWork from homeMonday to Friday$17 per hour
...ISG has an opening for a Full time Mail Specialist. Insight Service Group is a leader in the medical and anti-fraud management industry. ~ Ability to multi task, and work... .... ~ Print and package files for remote users. ~ Friendly, and customer service...Remote workFull timeWork at officeLocal areaMonday to Friday- ...MDS is a proven, trusted and innovative leader in revenue cycle management. For over 30 years, MDS has successfully partnered with multiple hospitals and respected health systems across the nation. Medical Data Systems Inc. is seeking a professional, self-sufficient, highly...Remote workWork at office
- Aspirion Health Resources, LLC is seeking a Claims Specialist who will follow up with insurance carriers on underpaid claims and perform research on claim variances. Required qualifications include a High School Diploma, hospital billing experience, and strong healthcare...Remote job
- ...Reimbursement Specialist Job Category: Finance Requisition Number: REIMB00254... ...Posted: June 9, 2026 Full-Time Remote Allegiance Health Management Bossier City, LA 71111, USA Job... ...accounts that could benefit from an appeal and escalation with the payor. The...Remote workFull time
- ...Health Specialist ICF seeks a Health Specialist to support the Office of Head Start Region IV Training and Technical Assistance (TTA... ...health services for children birth to five, including work with management teams and program staff. ~1+ years' experience facilitating...Remote workContract workWork experience placementWork at officeWork from home
- ...IHMS USA, Inc. provides medical services to some of the world... ...developed accredited and compliant management systems that help ensure... ...The Electronic Medical Record Specialist is responsible for the creation... ...Health Record system provides remote access, required accounts, and...Remote workMinimum wageFull timeContract workWork at officeLocal area
$76k - $199.6k
...upon the best strategies to manage business relationships, understanding... ..., including Therapeutic Area Specialists, and Key Opinion Leaders (... ...skills. Effective at working remotely in collaboration with cross-... ...colleagues, including Field Medical and Account Management, to...Remote workPermanent employmentFull timeH1bLive inLocal areaVisa sponsorshipWork visaRelocation package$50k
Employer Industry: Behavioral Healthcare Management Why consider this job opportunity Starting pay up to $50,000 per... ...peer-to-peer reviews and coordinate urgent/expedited appeals Staff individual cases with medical doctors as required Maintain compliance with all...Remote job$24.95 - $35.96 per hour
...Description: JOB TITLE: Mental Health Specialist I Family Support Partner Supervisor SUPERVISOR... ..., Umatilla & Grant Counties, Oregon (remote in one of the counties listed until... ...the Clinical Director or the Clinical Manager, is responsible for the day to day oversight...Remote workHourly payContract workFor contractorsWork experience placementWork at officeImmediate startWork from homeLong distanceNight shift$248.5k - $373k
...You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you... ...challenges. Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing... ...of Insurance/Department of Managed Healthcare, and CMS regulatory responses...Remote jobMinimum wageWork experience placementLocal areaWork from home$60.3k - $133.4k
...personnel and all other entities involved in managing care. Identifies alternate treatment programs;... ...or similar clinical guidelines Knowledge of medical management policies and procedures This is a Telecommute (Remote) role: Must reside within 250 miles of the office...Remote workTemporary workWork at officeLocal areaImmediate start
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