Grievances & Appeals Specialist
$17 - $25.65 per hourHispanic Alliance for Career Enhancement
The Hispanic Alliance for Career Enhancement is seeking a dedicated professional to handle research on appeals, complaints, and grievances within a busy healthcare environment. Responsibilities include verifying claim payments and serving as a technical resource for colleagues. This position requires strong analytical skills, excellent communication abilities, and a good understanding of clinical terminology. A high school diploma or equivalent is required, with some college education preferred. The role offers full-time hours and a competitive pay range of $17.00 - $25.65 per hour. #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...SuggestedRemote 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...SuggestedRemote job
- 340B Health is looking for a motivated individual to manage the Appeals and Grievance process. This role requires communication with members, vendors, and providers to ensure the appeal process is completed accurately and timely. The ideal candidate should have a high school...SuggestedFull timePart time
- Blue Cross Blue Shield of Arizona is seeking a skilled professional for a clinical role addressing provider appeals and grievances. This position demands expertise in managed care while ensuring compliance with privacy regulations. The ideal candidate will possess a relevant...SuggestedRemote job
- 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...SuggestedRemote job
$22 - $23 per hour
...Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity with long-term potential and is US ( Remote ). Please review the job description below and contact me ASAP if you are interested. Job Diva ID: 26-07046 Pay Range: $22.00 - $...Contract workWork at officeLocal areaImmediate startRemote work- ...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...Hourly payContract workRemote workWeekend work
- 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
- ...Geisinger in Pennsylvania is hiring for a position focused on supporting the Appeals and Grievance process. The role involves acting as a liaison between members and the plan, ensuring compliance with regulations regarding denied claims and quality of care. The ideal candidate...
$50k - $55k
...Readmission reviews. Under the direction of the Appeals Department leaders, the Appeals Coordinator... ...work within the department. The Appeals Specialist level II performs research, investigation, and analysis of appeals, grievances, and other types of complaints filed by...Remote work$58.9k - $80.07k
...The Appeals & Grievances (A&G) unit processes member and non-contracted provider appeals for all of HF's line of businesses which include... ...Medicaid, dual enrollments, Medicare and complete care. Appeals Specialist is the subject matter expert responsible for non-clinical...Temporary workWork experience placement- A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage appeals and complaints. The ideal candidate will have 3+ years of healthcare experience, a strong background in claims processing, and...Remote 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
- ...Prism Vision Group is seeking a Revenue Cycle Specialist located at Spokane Eye Clinic, Spokane, WA. This role involves handling billing and collecting from assigned payors, ensuring compliance with regulations and customer service excellence. Candidates should possess...
- ...contract negotiations and interpretation, investigation and processing of employee grievances and hospital discipline. Conducts hearings at the Corporate level, participates in arbitration appeals and maintains liaison with employee union representatives and personnel labor...Contract workWork at officeLocal areaWork from homeShift work
- Ventra Health Inc. is seeking a Certified Coding Denials Specialist to work remotely in a full-time role. The specialist will manage claim edits and rejection work queues, ensuring timely investigation and resolution of health plan denials while adhering to departmental...Remote jobFull time
- ...on the quality of our health plan members' lives. The A&G Specialist will process the department correspondence, incoming and outgoing... ...the A&G Coordinators and Director, inorder to insure that grievances and appeals are processed within established regulatory time frames and...
$58.5k - $69.97k
Position Summary We have an exciting opportunity to join our team as a Data Analyst, Financial Data Governance and Quality. The successful candidate reports to the Assistant Manager, Financial Data Governance and Quality and will maintain and analyze data within PeopleSoft...Work experience placement- Kids for the Future is looking for a Reimbursement Specialist who will be responsible for resolving insurance claims and ensuring timely reimbursements. The position is remote and requires in-depth knowledge of billing practices and strong communication skills. Candidates...Remote job
- ...NYC based Prestigious legal services firm seeks an E-Billing Analyst to join their team! Responsibilities Prepare and submit appeals for rejected invoices. Logging reduced invoices for all clients. Following up with firm timekeepers to prepare for appeal replies. Negotiating...
$28.85 - $35 per hour
...engaged to conduct a search for a Denials & Revenue Recovery Specialist for a fast-growing healthcare revenue recovery organization .... ...specific workflows. You will manage assigned denial queues, submit appeals, and follow claims through to final resolution while...Hourly payTemporary workInterim roleRemote workFlexible hours- ...of Pennsylvania is seeking a Legal Assistant 1 for the Department of Human Services. This full-time role involves assisting in the appeals process and supporting Administrative Law Judges. The ideal candidate must have at least three years of responsible clerical, enforcement...Remote jobFull timePart time
$60k - $80k
...in lots; and execute bids at sale. Collaborate with marketing, editorial, and specialists to develop content or programming that highlights the continued relevance of antiques and appeals to next generation collectors. Working with the Furniture, Silver and European...Work at officeLocal area$22 per hour
...in the medical alarm industry, seeking a seasoned Revenue Cycle Specialist with health insurance claims experience to fill a role in the... ...reimbursement within established payer timelines. Review, analyze, and appeal denied or underpaid claims in accordance with payer policies...Hourly payPermanent employmentFull timeTemporary workWork at officeRemote work- ...the primary HR advisor for physician and APP employee relations matters, including performance concerns, professionalism issues, grievances, complaints, conflicts, and workplace conduct issues. Leads or supports workplace investigations involving providers, including allegations...Contract work
- ...in dealing with patients and insurance companies. Understanding of insurance contractual agreements, payer policies, guidelines and appeals process. Sharp analytical abilities are required in order to resolve the patient accounts in a timely and accurate manner....Shift work
$65k
...Yr. Max USD $68,000.00/Yr. Position Overview The Revenue Cycle Specialist reports to the Revenue Cycle Manager and will interface with... ...basis Reconcile claim denial reports on weekly basis, prepare appeals and implementation of programs to prevent future billing issues...Local area- ...Carolina, and Eastern North Carolina. The Field Reimbursement Specialist (FRS) serves as a subject‑matter expert on reimbursement, access... ...in pharmacy benefit reimbursement, prior authorizations, appeals, and specialty pharmacies is essential, as the supported medication...Work at officeLocal areaNight shift
- ...claims end-to-end, from portal follow-ups and payor calls to appeals and medical records, so providers can resolve more denials, recover... ...the Role We're looking for a Senior Accounts Receivable Specialist to join our client onboarding team a small group of...Permanent employmentWork at officeImmediate startFlexible hours
$10 per hour
...Professional Coder (CPC) to manage denial issues and ensure accurate medical billing. The ideal candidate will analyze denials, manage appeals, and ensure compliance with coding guidelines. Applicants should have a CPC certification and a strong coding background. This full...Remote jobFull time
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