Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote Appeals & Grievances Specialist

Point32Health, Inc.

Canton, MA
  • Remote job

Point32Health, Inc. is seeking an Appeals and Grievance Coordinator to manage day-to-day tasks within the A&G department. You will process mail, assign cases, and support analysts while ensuring compliance with regulatory timelines. The role requires 1-2 years of relevant experience, strong organizational and communication skills, and proficiency in Excel and Word. A work-from-home option may be available as needed, with some on-site work in the Canton area. #J-18808-Ljbffr Point32Health, Inc.

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Appeals & Grievances Specialist in Canton, MA vacancy
  •  ...Healthfirst is seeking a Grievance Specialist to join its Appeals & Grievances team in a fully remote position. You will manage and resolve member complaints across Medicare, Medicaid, and other Healthfirst programs, coordinating with internal teams and external partners... 
    Remote work

    Health First

    United States
    2 days ago
  •  ...Workday is seeking a Grievance & Appeal Specialist to address appeals within required timeframes and ensure contractual obligations are met. The...  ...Procedures to ensure compliance with regulatory standards. This remote position requires strong communication, confidentiality,... 
    Remote work

    Workday

    United States
    5 days ago
  • $46.37k - $60.86k

     ...Hi, we're Oscar. We're hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT team. Oscar is the first health insurance company...  ...into our CGA Team Lead. Work Location: This is a remote position, open to candidates who reside in: Arizona,... 
    Remote job
    Full time
    Work at office

    Oscar Health

    Atlanta, GA
    10 days ago
  • $60.78k

     ...Appeals And Grievances Specialist II Job Category: Customer Service Department: 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 work
    Full time
    Local area
    Shift work
    Weekend work

    LOS Angeles Care Health Plan

    Los Angeles, CA
    3 days ago
  • 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

    Health First

    New York, NY
    3 days ago
  • $23 per hour

    TEKsystems is seeking a Contract Grievances and Appeals Specialist for a fully remote role based out of Columbus, OH. The position analyzes and resolves verbal and written claims and appeals from providers and members, and prepares response letters. This is a contract... 
    Remote job
    Hourly pay
    Contract work

    TEKsystems

    Columbus, OH
    3 days 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 regulatory... 
    Remote work
    Full time
    Contract work
    Work at office

    Molina Healthcare

    Remote
    6 days ago
  • $20 - $21 per hour

     ...greater-NYC), OH, SC, TX, UT, WA (outside greater-Seattle), WI Responsibilities:   Research & resolve member/provider appeals, grievances, and complaints. Review claims, benefits, records & contracts; prepare timely resolutions and correspondence. Qualifications... 
    Remote job
    Temporary work

    Collabera

    Austin, TX
    1 day ago
  • $26.99 per hour

    We are currently seeking experienced Appeals & Grievances Specialists!  This is a full remote opportunity paying $27/hr.  The ideal candidate has experience investigating and responding in writing to internal and regulatory complaints.  Experience in ACA is a plus.  If... 
    Remote work
    Hourly pay
    Permanent employment
    Temporary work
    Work experience placement
    Shift work
    New York, NY
    1 day ago
  •  ...Member Appeals Specialist Primary responsibilities would include triaging incoming appeals/grievances, categorizing them appropriately, assigning them to the team, making outbound calls when necessary. Also checking voicemails, responding to emails/voicemails. The... 
    Remote work
    Traineeship

    Saviance

    United States
    2 days ago
  • A Medical Claims Organizations is in the immediate need of Grievance and Appeals Specialist with experience in grievances and appeals to join the team. The Grievance and Appeals Specialist is responsible for reviewing, investigating, and resolving member and provider grievances... 
    Immediate start

    Robert Half

    San Bernardino, CA
    5 days ago
  • Humana Inc. is seeking a Grievances & Appeals Representative 3 to handle expedited Medicaid and AIP (dual) appeals, reviewing clinical documentation...  ...report to the Grievances & Appeals Supervisor and work in a remote setup with possible travel for training or meetings.J-18808-... 
    Remote job

    Humana

    Boise, ID
    4 days ago
  •  ...denials, 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... 

    MDA Edge

    Irving, TX
    4 days ago
  • $51k - $80.07k

    The Grievance Specialist is a member of the Appeals & Grievances (A&G) team at Healthfirst and is responsible for managing and resolving member or authorized...  ...regulatory requirements. **This position is 100% remote - Schedule M-F, 8am-4:30pm or 8:30am-5pm EST Key Responsibilities... 
    Remote work
    Full time
    Contract work
    Temporary work
    Work experience placement
    Work at office

    HealthFirst

    Florida
    5 days ago
  • $51k - $80.07k

    The Appeals & Grievances (A&G) unit processes member and non-contracted provider appeals for all...  ..., Medicare and complete care. Appeals Specialist is the subject matter expert responsible...  ...cases. **This position is 100% Remote M-F, 8am-5pm or 8:30pm-5pm EST. Key... 
    Remote work
    Full time
    Temporary work
    Work experience placement

    HealthFirst

    Connecticut
    5 days ago
  • $66.3k - $79.8k

    Overview Resolves grievances, appeals and external reviews for VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Fully Integrated Dual Advantage (FIDA) and Select Health. Ensures regulatory compliance, timeliness requirements and accuracy... 
    Work experience placement
    Work at office
    Flexible hours

    VNS Health

    New York, NY
    4 days ago
  • A healthcare service company is seeking a G&A Coordinator in Detroit, MI. This role involves processing appeals, grievances, and inquiries from members, requiring strong analytical and communication skills. The ideal candidate will have a bachelor's degree and experience... 

    EPITEC

    Detroit, MI
    3 days ago
  • $48.5k - $70.5k

     ...year history of providing health insurance that works for our members, no matter their circumstances. Job Summary The Appeals and Grievance Specialist is responsible for managing the resolution process of medical and pharmacy member appeals and/or member generated... 
    Contract work
    Work at office
    Flexible hours

    WellSense Health Plan

    Boston, MA
    4 days ago
  • $22 - $25 per hour

     ...communities." Western Health Advantage Western Health Advantage (WHA) is seeking a detail-oriented and customer-focused Appeals & Grievances Specialist to join our team. In this fast-paced role, you will support members by managing appeals and grievances while ensuring... 
    Hourly pay
    Work experience placement

    Western Health Advantage

    Brooklyn, NY
    3 days ago
  • $31.25 - $33.65 per hour

     ...Appeals Specialist Remote GeneDx delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable... 
    Remote work
    Work at office
    Work from home
    Home office

    GeneDx

    United States
    1 day ago
  • $29.7 - $31.8 per hour

     ...between $29.70 - $31.80 based on experience The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the...  ...and improve patient and client experiences. ~ This is a remote position; however, candidates must be willing and able to travel... 
    Remote work
    Temporary work
    Work at office
    Local area

    Ensemble Health Partners

    Oregon State
    11 hours ago
  • $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 adjudication... 
    Remote work
    Minimum wage
    Work experience placement
    Local area
    Work from home

    UnitedHealth Group

    Cypress, CA
    5 days ago
  •  ...Researching and responding to inquiries from various stakeholders, the full-time Appeals Specialist will manage the appeals/dispute process remotely, ensuring timely and accurate customer service and resolution of issues. Key responsibilities Provides customer service... 
    Remote work
    Full time
    Contract work
    For contractors
    Work at office

    Virtual Vocations Inc

    United States
    1 day ago
  • Molina Healthcare in Kentucky is seeking a Claims Support Specialist to review and resolve member and provider complaints and communicate...  ...in line with CMS standards. The role involves researching appeals and grievances, requesting and reviewing medical records and bills,... 
    Contract work

    Molina Healthcare

    Brooklyn, NY
    6 days ago
  •  ...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 work

    Quadax

    Cleveland, OH
    4 days ago
  •  ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication across multiple plans. The role...  ...collaboration with medical directors and network management. Remote work within the U.S. is supported, with a focus on improving... 
    Remote work

    Texas Health Institute

    United States
    4 days ago
  • $25 - $31 per hour

     ...Responsible for all activities associated with appeal analysis, decision-making and closure as...  .... Collaborate effectively with coding specialists, appeal nurses, physician reviewers, and...  ...) Workplace Type This is a fully remote position. Application Deadline This... 
    Remote work
    Contract work
    Temporary work
    Work experience placement

    TEKsystems

    Portland, OR
    3 days ago
  • UT Southwestern Medical Center in Dallas, TX, seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers, maximizing collections. The role emphasizes follow-up and resolution of denied claims with... 
    Remote job

    University of Texas Southwestern Medical Center

    Dallas, TX
    4 days ago
  • $35.36k

     ...is seeking a compassionate, organized, and veteran-focused  Appeals Specialist to support veterans and their families in navigating VA disability...  ...you changed the life of someone who served Benefits Remote-first work, from anywhere in the USA Employer-sponsored... 
    Remote work
    Full time

    True Vet Solutions

    Remote
    6 days ago
  •  ...Job Description Job Description Job Title:   Grievance & Appeals Coordinator I Location: Remote in Indiana (**MUST be a resident of Indiana) Pay: $22 hourly - *weekly pay Position Purpose:  Analyze and resolve verbal and written claims and authorization appeals... 
    Remote work
    Hourly pay
    Weekly pay
    Full time

    Professional Management Enterprises

    Indianapolis, IN
    4 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote Appeals & Grievances Specialist. Be the first to apply!