Clinical Appeals Specialist - Remote
$83.1k - $120.36kHealthfirst, Inc.
- Remote job
Healthfirst, Inc. seeks a Clinical Specialist for its Appeals & Grievances unit in New York City. This role involves managing clinical cases, ensuring compliance, and resolving member complaints. The position offers a hiring range of $83,100 - $120,360 for NYC residents. The ideal candidate will have experience in clinical practice and a sound understanding of utilization review guidelines. The job requires proficiency in various applications, independent case management, and communication with teams. #J-18808-Ljbffr Healthfirst, Inc.
$83.1k - $120.36k
...Appeals & Grievances Clinical Specialist The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are... ...participating and non-participating providers. This is either a remote or on-site position located at either the 100 Church...Remote workContract workTemporary workWork experience placementLocal area$83.1k - $120.36k
Position Summary The Appeals & Grievances (A&G) unit manages Healthfirst... ...authorization or delivery of clinical and non‑clinical services. A&... ...manner. The A&G Clinical Specialist is the subject‑matter expert... .... This position is either remote or on‑site, located at 100 Church...Remote workContract workLocal area- A healthcare services company is seeking a Clinical Appeal and Grievance Nurse to manage medical necessity and benefit appeals. This remote role requires an active RN or LPN license and a minimum of 5 years' experience in Clinical Appeals and Grievances. Key responsibilities...Remote jobWork at office
- ...Clinical Denial Management Specialist III With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence... ...regarding reimbursement discrepancies. Create and submit appeals for clinical and coding denials in accordance with payer...Remote workFull timeWork from homeMonday to FridayFlexible hoursShift work
$75k - $105k
...Technologies company, builds clinical AI that is transforming how hospitals... ...improve quality scores, and appeal every denial. Become a... ...com/careers. Clinical Coding Specialist (Inpatient) Role As an Inpatient... ...‑quality. This role is fully remote within the US. What You’ll Do...Remote work- ...Reality? Have you ever worked in a clinical setting and/or have a desire... ...the advancement of medicine appeal to you? Our mission is to... ...position called XR Clinical Specialist. The individuals we hire for... ...assistance. Provides hands on and remote clinical support to customers...Remote workContract workImmediate startRelocationFlexible hours
- ...total cost of care. We are currently looking for a UM Clinical Support Specialist to join our growing team! The UM Clinical Support... ...needed, and supporting compliance, training, and appeal processes Office Location: Remote Essential Functions: Works independently with...Remote workFull timeWork at officeLocal areaWork from home
- ...Sinai Medical Center of Florida, Inc. is seeking a Senior Clinical Denials Coordinator to manage appeals for level-of-care and medical necessity denials. The... ...in critical care or clinical denials. The position is remote and offers comprehensive benefits including health...Remote job
- ...reading! Position Overview At PHIL, our Clinical Support Associates serve as the first line... ...approximately 40–60 inquiries per day. In this fully remote position, you will handle inbound calls,... ...authorizations, tier exceptions, and appeals Use professionalism, de‑escalation and...Remote workWork at office
$64.39 - $82.9 per hour
...Angeles, CA, USA Onsite or Remote Fully On-Site... ...devoted to using your specialized clinical laboratory expertise to uncover... ...Clinical Laboratory Science Specialist for Point of Care Testing (POCT... ...misconduct; or have filed an appeal of a finding of substantiated...Remote workHourly payMonday to Friday- Mount Sinai Medical Center in Miami Beach is seeking a Sr. Clinical Denials Coordinator to manage and appeal medical necessity denials using clinical judgment and payer policy knowledge. This role requires experience in critical care or similar fields. Responsibilities...
- Mount Sinai Medical Center of Florida, Inc. is seeking a qualified Sr. Clinical Denials Coordinator in Miami Beach. This role involves managing and appealing medical necessity denials using clinical judgment and payer policy knowledge. The ideal candidate must possess...
- ...University of Chicago Medicine , as a Clinical Pharmacist Specialist for the Infusion Patient Access... ...patient population. This department remotely supports outpatient infusion care to... ...authorization or claim denial peer-to-peers and appeals, financial assistance evaluation,...Remote workFull timeLive inRelocation packageFlexible hoursShift work
- ...is seeking a detail-oriented and clinically experienced Clinical Audit Specialist to support behavioral health payer... ...utilization review, and medical necessity appeals for its counseling and residential... ...requirements. Hybrid or remote and flexible scheduling is...Remote workPart timeWork at officeImmediate startFlexible hours
- ...! Gateway Rehab is searching for a home-based Part-time Clinical Admissions Specialist who is responsible for pre-admission level of care assessment and case management of patients. This position is remote, but the ideal candidate must live in the Pittsburgh, PA region...Remote workPart timeLive inWork from homeRelocation packageShift workWeekend workAfternoon shift
$84.7k - $157.3k
...A leading medical device company based in Massachusetts seeks a Clinical Advisor to drive utilization of the TEG product line. This remote role involves significant territory management, requiring a degree in Nursing and substantial expertise in complex medical devices...Remote work$64.39 - $82.9 per hour
...Monica, CA, USA Onsite or Remote Fully On-Site... ...about applying your specialized clinical laboratory expertise to uncover... ...Clinical Laboratory Scientist Specialist for Quality and Compliance, you... ...misconduct; or have filed an appeal of a finding of substantiated...Remote workHourly payMonday to Friday- ...OCS Specialist The OCS Specialist maximizes and supports the use of the OCS for organ retrieval... ...during standard working hours, either remotely from home or as assigned, including but... ...) Ability to fly domestically to clinical sites within and outside of home regions...Remote workTemporary workWork at officeWork from homeWorldwideFlexible hours
- ...Edwards Lifesciences Belgium is seeking a Sr Specialist, Clinical Imaging to analyze imaging modalities for case planning in the Transcatheter... ...M3 therapy team in achieving exceptional outcomes. Remote candidates based in the US are welcome, with occasional travel...Remote work
- ...A global healthcare company is seeking a Clinical Specialist for a remote role to support patients and healthcare providers in neuromodulation. Candidates must have substantial clinical experience and a valid driver's license. The position involves surgical support, patient...Remote work
- A healthcare provider seeks a skilled individual to manage clinically-based appeals, ensuring effective communication with payers. This role requires a Bachelor’s in Nursing and a valid RN license, along with five years of clinical experience. Responsibilities include...
- MedImpact Healthcare Systems, Inc. is seeking a Clinical Appeals Review & Compliance Specialist in San Diego. The role involves reviewing Clinical Appeals, utilizing established clinical guidelines, and collaborating with internal teams on appeal processing. Candidates...
$108k - $153k
A leading medical technology firm is seeking a Sr Specialist in Clinical Imaging to analyze imaging modalities for case planning in the Transcatheter... ...and strong imaging analysis skills. This role is primarily remote with occasional travel required. Competitive salary range is...Remote work$145k - $160k
...course of lives. Why join LivaNova's clinical team? You can play a major role in... ...hoc training when needed. The clinical specialist must both work independently within their... ...Program • Flexible Work Schedules #LI-Remote Welcome to impact. Welcome to innovation...Remote workFor contractorsWork from homeWorldwideFlexible hoursWeekend work$90k - $125k
...A leading healthcare technology company is seeking a Clinical Specialist to address customer clinical needs within an assigned territory. This... ...$125,000 along with a comprehensive benefits package is offered. Remote work is available for this position. #J-18808-Ljbffr...Remote work- A medical technology company is seeking a Senior Clinical Imaging Specialist to join their team in Santa Cruz, CA. This remote position requires strong organizational skills and a background in clinical imaging, particularly in echocardiography and CT. The role involves...Remote work
- ...NutraCo is seeking a compassionate Registered Dietitian to join our team in Newburgh, NY, providing clinical nutrition care to residents in Long Term Care facilities. This role involves developing personalized nutrition plans, collaborating with healthcare teams, and...Remote work
$131k - $166k
...Aortic Clinical Specialist Field Req Id: 1730 State/Province: Washington Business: Gore Medical Products... ...Marketing Sub-Category: Sales Work Arrangement: Remote Posting Start Date: 5/26/26 Posting End Date...Remote workLocal areaWork from homeVisa sponsorshipNight shiftWeekend work- ...A leading medical technology company is seeking a Clinical Specialist in Alabama to address customer clinical needs and demonstrate their ultrasound products. This role will partner with Territory Managers, ensuring customer satisfaction and promoting product adoption....Remote work
- ...A clinical trial solutions provider is seeking a Medical Consultant/Central Imaging Reviewer for remote work. The role includes performing central imaging reviews for various modalities, interpreting medical images, and applying clinical trial protocols. Ideal candidates...Remote workFlexible hours
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