Remote Grievance & Appeals Specialist
Elevance Health
Elevance Health is seeking a Grievance/Appeals Representative I to work virtually from Grand Prairie, Texas. This position involves investigating customer grievances and appeals related to service coverage while managing communications with customers and regulatory agencies. The ideal candidate must have a high school diploma and at least one year of relevant experience in health insurance or customer service. Strong communication and organizational skills are preferred. Join Elevance Health and contribute to improving customer satisfaction. #J-18808-Ljbffr
- ...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
$60.78k
...Appeals And Grievances Specialist II Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...Remote workFull timeLocal areaShift workWeekend work- 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
- 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 And Provider Complaint Resolution Specialist 100% remote candidates must live in one of the preferred 15 states (AZ, FL, GA... ...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
$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$50k - $55k
...Appeals Coordinator Level II At MedReview, our mission is to bring... ...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 work$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- Sagility is seeking an Appeals and Grievance Coordinator who will manage and resolve member and provider complaints while adhering to regulatory requirements. This role involves conducting investigations, documenting actions, and ensuring compliance. As a key contact for...Remote jobWork from home
$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$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- ...TeamHEALTH is looking for a Denials and Appeals Representative to handle denials and appeals for patient accounts in a cooperative team environment. The ideal candidate has at least two years of experience with insurance denial processes. Responsibilities include processing...Remote work
- ...Pride Health is seeking a Grievances and Appeals Nurse for a remote contract position. This role is vital in investigating and resolving grievances and appeals efficiently for a well-known client. Responsibilities include acting as a subject matter expert, ensuring compliance...Remote workContract work
$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- 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...
$19 - $21 per hour
...Appeals Specialist Respond to all assigned levels of denials by submitting appeal letters and required documentation to insurance companies... ...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$24 - $25 per hour
...States and we are currently looking to add a Revenue Cycle Appeals & Recovery Specialist to join our fast-paced and energetic team. The ideal... ...professional environment, apply today! This role is full time, remote with a base rate of $24 to $25 per hour and a full benefit...Remote workHourly payFull timeLive inShift work- 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
$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- 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
- 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 experience...Remote job
- ...Hospital is searching for a Senior Denials Specialist for the comprehensive review, analysis,... ...of denied hospital claims through the appeals process. You'll work to ensure optimal reimbursement... ...work model to balance on-site and remote work. #J-18808-Ljbffr Tampa General...Remote work
- ...Senior Appeals Specialist Job Category: Medical Billing Full-Time Remote Location: Middleburg Heights, OH 44130, USA +1 more locations Description Key Responsibilities: Work as needed in all appeal worklists, potentially with a focus on contracted...Remote workFull time
$248.5k - $373k
UnitedHealth Group is looking for an Appeals and Grievances Medical Director to oversee clinical reviews and adjudications. This role offers the flexibility to work remotely from anywhere in the U.S. Key responsibilities include reviewing appeals cases, communicating with...Remote job- ...Denials Specialist Insight Global is seeking a fully remote Denials Specialist to support a Healthcare AI client. This is a part-time opportunity working... ...week where candidates will leverage their denials and appeals expertise to evaluate and improve AI-driven denial...Remote workContract workPart timeMonday to FridayFlexible hoursShift workWeekend work
$248.5k - $373k
...Growing 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 jobMinimum wageWork experience placementLocal areaWork from home$248.5k - $373k
UnitedHealth Group is seeking an Appeals And Grievances Medical Director. This role is crucial for the clinical review and adjudication of appeals... ...and grievances cases for UnitedHealthcare. You'll work remotely from anywhere within the U.S., collaborating closely with...Remote job- Summary We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role as Appeals Specialist,... ...business need to work occasional overtime. This role is fully remote or can sit onsite at 26 Century Blvd, Suite ST610 Nashville,...Remote workFull timeContract workFor contractorsWork experience placementSecond jobCurrently hiringWork at officeLocal areaShift work
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