Remote Appeals & Grievances Specialist
Geisinger Health System
New York, NY
- 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
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Appeals & Grievances Specialist in New York, NY vacancy
$14.9 - $29.06 per hour
...(CMS). Responsibilities Enters denials and requests for appeals into information system and prepares documentation for further... ...language for letters and prepares responses to member appeals and grievances. Elevates appropriate appeals to the next level for review....Remote workHourly payWork experience placementWork at officeWeekend workMolina Healthcare
San Antonio, TX3 days 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 workFull time
L.A. Care Health Plan
Los Angeles, CA1 day ago - ...Medicare and Medicaid Services (CMS). Essential Job Duties • Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or...Remote workContract workWork at office
Molina Healthcare
United States11 hours ago - ...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
Blue Cross Blue Shield of Arizona
Phoenix, AZ5 days ago - 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 job
- Firstsource Solutions Limited is seeking a full-time hourly Remote Customer Service Representative in the United States. The role involves reviewing grievance and appeals documents, classifying disputes, and managing member information in line with HIPAA regulations. The...Remote jobHourly payFull time
$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- 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
- ...Member Complaint Resolution Specialist This position is for five locations. Candidates must live in one of the preferred... ...Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from Molina members, providers and...Remote workContract workLive inMonday to Friday
Saviance
United States3 days ago $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... ...frequent interruptions Remote Work Requirements High speed...Remote workMed Review Inc
New York, NY2 days ago$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 jobHourly payWork at office- ...Commercial Appeals and Grievance Registered Nurse (RN) The Commercial Appeals and Grievance RN reviews and processes member-generated pre-service and post-service appeals and grievances. This role is responsible for concurrent review of medical records and documentation...Work at officeLocal area
Wollborg Michelson Recruiting
Oakland, CA5 days ago $18.33 per hour
...Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $18.33 Maximum Offer $27.25 Now Hiring: Appeals and Grievance Specialist Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled Appeals and Grievance Specialist...Full timeTemporary workLocal areaImmediate startShift workPresbyterian Healthcare Services
Albuquerque, NM3 days ago$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 weekMedica Services Company LLC
Minnetonka, MN1 day ago- ..., 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...
Macpower Digital Assets Edge
Irving, TX2 days ago $45.9k - $68.78k
Medica Health Management LLC is looking for an Appeals and Grievance Specialist responsible for managing member complaints and grievances, conducting research, and ensuring timely resolutions. This role requires collaboration across Operations, Health Services, and Legal...$29.94 - $33.68 per hour
Job Description As the Specialist, Grievances and Appeals you will participate in the daily operations of the Clinical Grievances and Appeals team. Under the direction of the Interim Supervisor of Grievances and Appeals, you will help to investigate and resolve member...Hourly payTemporary workWork experience placementInterim roleWork at office$45.9k - $68.78k
Medica Services Company LLC in Minnetonka is looking for an Appeals and Grievance Specialist to manage member concerns and ensure timely resolutions. The role requires a high school diploma, strong analytical skills, and up to 5 years of experience in healthcare operations...3 days per week$24 - $24.5 per hour
Fallon Health in Worcester, MA is hiring a Healthcare Triage Administrator. This position supports the Appeals and Grievances process, handling member and provider interactions while ensuring compliance with regulatory standards. The ideal candidate will have a high school...Hourly pay- Blue Cross Blue Shield of Arizona seeks a Clinical Appeals Specialist to utilize their clinical acumen for resolving member and provider appeals, grievances, and claims. The role requires a minimum of 1 year of healthcare-related experience and an Associate's Degree in...
- ...A healthcare company is seeking a skilled Appeals Processor III to work remotely in the United States. This role involves reviewing and processing healthcare appeals related to Medicaid or Medicare coverage decisions. The ideal candidate will have at least 2 years of...Remote work
Ghost RX
New York, NY5 days ago - 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 work
Med Review Inc
New York, NY2 days 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 workHourly payQuadax
Cleveland, OH5 days ago$95k - $115k
Western Health Advantage seeks an Appeals & Grievances Nurse (RN) for their Utilization Management team in Sacramento, CA. This full-time role offers a salary between $95,000 and $115,000 annually. The nurse will collaborate with various stakeholders to ensure compliance...Full time$74.8k - $78.7k
...Carolina); Omaha, NE (Nebraska); Work from Home Work Arrangement: Remote : Work at home employee residing outside of a commutable... ...opportunity. Requisition #: 76084 The Role at a Glance As an Appeals Specialist you will be responsible for being a product subject matter expert...Remote workContract workTemporary workWork experience placementWork at officeWork from homeRelocation packageLincoln Financial Services
Papillion, NE5 days ago- Maximus is seeking a Senior Appeals Administrator for their California Independent Medical Review team. This role is vital in ensuring timely resolutions for medical review cases while enhancing the appeals process. The ideal candidate will have an associate degree with...Remote jobWork from homeFlexible hours
- ...Job Posting Title Review & Appeals Specialist I Applicants must be authorized to work... ...employees in hybrid positions work both remotely and onsite in the NCCPA headquarters based... ...in business, healthcare, appeals and grievances, state medical board, legal, or...Remote workWork at office
NCCPA
Peachtree Corners, GA4 days ago - ...Senior Appeals Specialist Job Category: Medical Billing Full-Time Remote Middleburg Heights, OH 44130, USA +1 more locations Description Key Responsibilities: Work as needed in all appeal worklists, potentially with a focus on contracted or sensitive...Remote workFull time
Quadax
United States4 days ago $23 per hour
...A-Line Staffing is now hiring an Appeals Specialist II. This is a fully remote opportunity supporting Centene's Medicaid line of business. The Appeals Specialist II would be working for a Fortune 500 healthcare company and has career growth potential. This would be...Remote workHourly payFull timeImmediate startMonday to FridayA-Line Staffing Solutions
Austin, TX5 days ago$29 - $46.5 per hour
...health care in America's heartland. Facility: Remote SD (Central Time) Location: Remote, SD Address... ...Details Fully remote. Job Summary The Lead UM Specialist serves as the subject matter expert for appeals and denials, provides leadership, case oversight,...Remote workFull timePart timeWork from homeShift workDay shiftSanford Health
Sioux Falls, SD2 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Appeals & Grievances Specialist. Be the first to apply!
Related searches
- live chat specialist New York, NY
- mental health specialist New York, NY
- cash reconciliation specialist New York, NY
- instructional technology specialist New York, NY
- channel specialist New York, NY
- privacy specialist New York, NY
- assessment specialist New York, NY
- asset protection specialist New York, NY
- sourcing specialist New York, NY
- program specialist New York, NY