Remote Appeals & Grievances Specialist
Geisinger Health System
- Remote job
Geisinger is looking for a professional to provide support in the administration of the Appeals and Grievance process. This role involves liaising between members and the plan to address denied claims and benefit issues. Applicants should have a minimum of 5 years of relevant experience and a High School diploma or equivalent. The position requires strong communication skills and the ability to work independently. Benefits include healthcare coverage from day one, emphasizing an inclusive work environment. #J-18808-Ljbffr Geisinger
- ...Geisinger is seeking a dedicated professional to support the administration of the Appeals and Grievance process. The role involves acting as a liaison between members and the Plan regarding denied claims, services, and other concerns. Responsibilities include managing...Remote 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- ...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 workFull time
- 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
- ...employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the... ...resolving and responding to requests for member and provider appeals, grievances, reconsiderations and corrected claims for all lines of business...Remote workFull timeContract workWork experience placementWork at officeLocal area1 day per week
$60.78k
Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID:... ...requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in...Remote workFull timeLocal areaShift workWeekend work$18 - $24 per hour
...Pay Rate: $18 to $24 per hour Summary: ~ Work Mode: Remote Responsibilities: Triage incoming appeals and grievances, categorize them appropriately, and assign them to the team. Make outbound calls when necessary and check voicemails. Respond...Remote workHourly pay$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... ...incoming member appeals and grievances. Assign and manage appeals from intake...Remote workWork at officeMonday to Friday$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...Remote workHourly payWork at office$48.6k - $83.16k
...Responsible for processing expedited appeals: those that are complex in nature, require... ...times of the Expedited Appeal unit, the Specialists are required to work weekends and holidays... ...versed in all aspects of the complaint, grievance and appeal process and be able to...Remote workHourly payContract workWeekend work$50k - $55k
.... Under the direction of the Appeals Department leaders, the Appeals... ...the department. The Appeals Specialist level II performs research,... ...investigation, and analysis of appeals, grievances, and other types of... ...atmosphere of frequent interruptions Remote Work Requirements High speed...Remote work- ..., member and provider complaints, and reconsideration and redetermination requests. Review and respond to complaints, grievances and appeals within the stated time frame for each request Certify that providers and members are reimbursed accordingly using Medicare...
$45.9k - $78.6k
...a community of connected care, where coordinated, quality service is the norm and every member feels valued. Medica’s Appeals and Grievance Specialist plays a vital role in ensuring our members and providers receive clear, timely, and accurate resolutions to their concerns...Work experience placementWork at office3 days per week$32 - $33 per hour
...Appeals and Grievance Specialist Job details Posted 17 July 2026 Location Irving, TX Reference 1011652 Job description Appeals and Grievance Specialist II Location: Irving, TX 75039 Pay range: $32-33/hr Schedule: Monday...Contract workWorldwideMonday to Friday- ...Appeals & Grievance Specialist Schedule Monday – Friday Onsite Position Position Summary The Appeals & Grievance Specialist II is responsible for independently researching, reviewing, and resolving member and provider inquiries, complaints, appeals, and grievances. This...Work at officeMonday to Friday
- Top Healthcare Company is hiring an RN to work remotely as a Med Appeals & Grievance Specialist Coordinator! ***Must have a current RN License in Arizona or a Compact RN license*** Duties: - Perform in-depth analysis, clinical review and resolution of provider appeals...Remote workContract workTemporary workWork experience placementWork at officeLocal area
- ...Working remotely in a full-time capacity, the Appeals Specialist will leverage expertise in claims adjudication and risk management to guide clients through the appeals process, ensuring compliance and effective communication with stakeholders. Key responsibilities Reviews...Remote workFull timeContract 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- ...Appeals Specialist We are seeking a detail-oriented and experienced Appeals Specialist for our client in Middleburg Heights, Ohio. In this role... ...$19.50-$21.00 Monday-Friday 8am-5pm 3 months in office then remote Benefits offered Key responsibilities include reviewing...Remote workWork at officeMonday to Friday
- A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage... ...processing, and excellent analytical and communication skills. Remote work options are available along with competitive benefits...Remote job
$248.5k - $373k
...Appeals And Grievances Medical Director At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities... .... Work at home! You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges...Remote workMinimum wageWork experience placementLocal areaWork from home$248.5k - $373k
...together . Work at home! You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing clinical review and...Remote workMinimum wageWork experience placementLocal areaWork from home- ...Appeal & Grievance Coordinator Reviewer I We are seeking an Appeal & Grievance Coordinator Reviewer I to review and research medical appeals and grievances, analyze claims and medical records, and ensure timely resolution in compliance with HIPAA, CMS, and regulatory...Remote workWork at office
$246.1k - $344.2k
...medical decisions on complex appeal cases, exercising professional... ...-to address and resolve grievances and appeals. Participate in... ...Geriatrics, Hospitalist clinical specialists Work at Home Requirements... ...duplicate profiles. This is a remote position anywhere in the USA...Remote workFull timeTemporary workFor contractorsApprenticeshipInterim roleWork at officeWork from homeHome officeMonday to Friday- ...Appeals Specialist – BlueCross BlueShield of South Carolina BlueCross BlueShield of South Carolina (BCBSSC) is hiring an Appeals Specialist... ...redetermination letters. Location & Schedule Position may be onsite or remote. Onsite location: 26 Century Blvd, Suite ST610, Nashville, TN...Remote workFor contractorsWork experience placementWork at officeLocal areaShift work
- Blue Cross Blue Shield of Arizona needs a clinical expert for managing member and provider appeals. This remote position requires strong accuracy, knowledge of compliance timelines, and a focus on customer service. Applicants should possess a healthcare-related degree...Remote job
- ...Job Title Job Description Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established... ...and applying contract and regulatory provisions. This is a Remote Role Experience Experience handling a large load of work in...Remote workContract workApprenticeshipLocal area
$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...Remote jobHourly payFull time- ...Detroit, Michigan Analyst Contract Job Title: Grievance & Appeals Coordinator Location: Remote Job Description: Top 3 Required Skills/Experience - • Experience handling a large load of work in a fast-paced environment...Remote workContract workFlexible hours
- ...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:...Remote workContract work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Appeals & Grievances Specialist. Be the first to apply!
- amazon specialist New York, NY
- specialist New York, NY
- correctional behavioral specialist New York, NY
- entry level safety specialist New York, NY
- disclosure specialist New York, NY
- erp specialist New York, NY
- infection control specialist New York, NY
- cash reconciliation specialist New York, NY
- writing specialist New York, NY
- process specialist New York, NY

