Grievance & Appeals Coordinator
Virtual Vocations Inc
Managing and coordinating grievance and appeals processes, the full-time Grievance & Appeals Coordinator will review incoming cases, ensure compliance with regulatory guidelines, and collaborate with internal teams while working in a hybrid remote environment. Key responsibilities Manage and coordinate grievance and appeals processes in accordance with regulatory guidelines Review and process incoming grievances and appeals efficiently and accurately Collaborate with internal teams to resolve issues and communicate outcomes to stakeholders Required qualifications Experience in grievance and appeals processes or related compliance roles Familiarity with regulatory guidelines and policies relevant to grievance handling Ability to maintain detailed documentation of cases and correspondence Strong organizational skills to manage multiple cases simultaneously Proficiency in using office software and case management systems
$44.57k - $66.87k
..., and extend our innovation to employment settings by including remote and hybrid opportunities. As a Health Plans Grievance and Appeals Coordinator , you will play a critical role within Banner Plans & Networks, ensuring the timely intake, review, investigation, and...SuggestedDaily paidPart timeWork experience placementWork at officeRemote workMonday to FridayFlexible hoursShift work$35.36k - $53.35k
...Position Summary Responsible for intake, investigation and resolution of appeals, complaints and grievances scenarios for all products, which may contain multiple issues and, may require coordination of responses from multiple business units. Ensure timely, customer...SuggestedHourly payFull timeContract workLive inLocal area$42.47k - $53.1k
...efficiency, quality, and impact in their roles. Job Summary and Responsibilities Acentra Health is looking for a Appeals & Grievance Specialist to join our growing team. Job Summary: The Appeals and Grievance Specialist is responsible for conducting...SuggestedFull timeContract workLocal areaRemote work$19.43 - $32.98 per hour
...resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Key Details: Candidates must... ...on individual appeals and grievances May coordinate the Grievance and Appeals Committee Support the...SuggestedHourly payFull timePart timeWork at officeRemote workFlexible hours$22.99 per hour
...problem solver with sharp attention to detail looking for a work-from-home opportunity? We are seeking a dedicated Grievance and Appeals Intake Coordinator to join our collaborative operations team! Save time and money by ditching the daily commute and working...SuggestedHourly payTemporary workWork experience placementWork from homeHome officeMonday to FridayFlexible hoursShift work- ...Strategic Staffing Solutions is currently looking for a Grievance & Appeals Coordinator, a W2 contract engagement with one of our largest clients in Detroit, MI! REMOTE!! Title: Grievance & Appeals Coordinator Location : Detroit, MI (Fully Remote) Duration: 1...Contract workRemote work
$23.22 - $34.84 per hour
...unless an accommodation is granted as required by law. ~ Shift hours: Mon, Tues, Sat, Sun 8:30 am – 7:00 pm CST Grievance & Appeals Coordinator Responsibilities Summarizes and presents essential information for the clinical specialist or medical/dental director...Full timeWork at officeLocal areaShift work- A staffing solutions company is seeking a Grievance & Appeals Coordinator for a fully remote position in Detroit, MI. This role involves processing appeals, grievances, and inquiries while maintaining accurate documentation and effective communication. The ideal candidate...Contract workRemote work
$22 - $22.5 per hour
...Base pay range $22.00/hr - $22.50/hr Immediate need for a talented Grievance & Appeals Coordinator I . This is a 03+ Months Contract opportunity with long-term potential and is located in GA (Remote) . Please review the job description below and contact me ASAP...Contract workLocal areaImmediate startRemote work$23.22 - $34.84 per hour
A leading health insurance provider is seeking a Grievance & Appeals Coordinator to work virtually full-time, with responsibilities including summarizing complaints, ensuring resolution of grievances, and documenting interactions. The ideal candidate should possess a high...Hourly payFull timeRemote work- ...Randstad USA is seeking a Grievance and Appeals Intake Coordinator to join our operations team in a work‑from‑home setting. You will screen executive complaints, member grievances, and provider appeals in the PRIME platform, classify cases, and route them to specialized...Remote workWork from homeFlexible hoursWeekday work
- ProPivotal in Hingham, MA is seeking a Medicare Advantage Grievance Coordinator. This on-site role involves processing grievances, appeals, or member complaints within a structured, compliant environment. You will work under CMS guidelines, maintain precise case notes,...Hourly payWeekly pay
- MJHS seeks an Appeals & Grievances Coordinator to manage non-clinical aspects of member and provider appeals and grievances, ensuring accurate intake, validation, and timely processing in compliance with CMS, DOH, and Elderplan policies. The role includes case setup, triage...
- CVS Health in Columbus, OH is seeking a detail-oriented Appeals Specialist to oversee intake, investigation and resolution of appeals, complaints and grievances across products. You will coordinate responses from multiple units, ensure timely, customer-focused communication...
- Banner Health is seeking a Health Plans Grievance and Appeals Coordinator to manage intake, review, and resolution of grievances, appeals, and provider disputes. The role requires strong attention to detail, excellent written communication, and the ability to navigate multiple...Remote job
$22 - $23 per hour
Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity with long-term potential and is US ( Remote ). Please review the job description below and contact me ASAP if you are interested. Job Diva ID: 26-07046 Pay Range: $22.00 -...Contract workWork at officeLocal areaImmediate startRemote work$20.19 - $28.13 per hour
...of providing health insurance that works for our members, no matter their circumstances. Job Summary: The Member Appeals and Grievances (A&G) Coordinator performs administrative functions associated with incoming Member Appeals and Grievances. The A&G Coordinator is responsible...Full timeWork at officeRemote workFlexible hoursWeekend workAfternoon shift$17 - $28.46 per hour
...at a time. Position Summary Review, research, and enter grievance and appeal cases within one business day of receipt. Monitor multiple... ...when needed. Participate in weekly team meetings with Intake Coordinators, analysts, Quality team members, managers, and project...Hourly payFull timeLocal area$19.43 - $32.98 per hour
...resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Key Details: Candidates must... ...files on individual appeals and grievances. May coordinate the Grievance and Appeals Committee. Support the...Hourly payFull timePart timeWork at officeRemote workFlexible hours$30 - $32 per hour
Overview Immediate need for a talented Grievance and Appeals Coordinators . This is a 06+months contract opportunity with long-term potential and is located in Portland, CA(Hybrid) . Job ID: 25-81619 Base pay range: $30.00/hr - $32.00/hr Responsibilities Manage grievances...Contract workLocal areaImmediate start$73.01k - $111.97k
...Services (CMS). Essential Job Duties • Supervises team responsible for the submission/resolution of member and provider appeals and grievances, and ensures resolutions are compliant with applicable standards and requirements. • Assesses and audits business...Full timeWork at officeRemote work$56.2k - $101k
...Position Purpose: Supervise the day to day operations of the Appeals and Grievance (A&G) staff and functions within the department ensuring productivity and quality metrics are met. Support the team on escalated or complex issues and monitor and distribute case load....Full timePart timeWork at officeRemote workWork from homeMonday to FridayFlexible hoursWeekend work- ...Medicare Appeals Coordinator In this role, you will take ownership of retrospective authorization appeals and high-priority escalated cases. You will dive into complex claims histories, collaborate closely with Clinical, Intake/Triage, and operational partners, and...
$107.7k - $199.3k
...Position Purpose: Responsible for oversight of member appeals and grievance processes. Directs and ensures the efficient operational management... ...for in-house legal involvement on sensitive cases, and coordinates with plan attorneys on litigated cases, helping to oversee...Full timePart timeWork at officeRemote workFlexible hours$57.45k - $68.22k
...matching up to 5% ~ Tuition reimbursement ~ Health & fitness benefits, discounts and resources Job Summary The MA Appeals and Grievances Specialist provides a world class customer service experience through processing and resolution of Medicare Advantage (MA)...Full timeFor contractorsImmediate startRemote workRelocation$38.48k - $73.4k
...community at a time. Position Summary Prepares, researches, and evaluates information necessary to resolve member complaints, appeals, and grievances. Reviews case documentation, analyzes benefit and policy information, and ensures accurate, timely, and compliant case...Hourly payFull timeWork experience placementWork at officeLocal area$30.7k - $66.5k
...• Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related... .... • Health claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria....Full timeContract workWork at officeRemote work$38.17k - $66.5k
...• Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related... .... • Health claims processing experience, including coordination of benefits (COB), subrogation and eligibility criteria....Full timeContract workWork at officeRemote work$60.78k
...Appeals and Grievances Specialist IIJob Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.) Established in 1997, L.A. Care Health...Full timeLocal areaRemote workShift 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 work
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