Remote Expedited Medicaid Appeals Specialist
Humana
Boise, ID
- Remote job
Humana Inc. is seeking a Grievances & Appeals Representative 3 to handle expedited Medicaid and AIP (dual) appeals, reviewing clinical documentation to determine if appeals are warranted. This fast-paced role requires proactive queue management and effective communication with managers and leads. You will report to the Grievances & Appeals Supervisor and work in a remote setup with possible travel for training or meetings. #J-18808-Ljbffr Humana
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Expedited Medicaid Appeals Specialist in Boise, ID vacancy
- Humana Inc. is seeking a Grievances & Appeals Representative 3 to handle expedited Medicaid and AIP (dual) appeals, reviewing clinical documentation to determine... ...the Grievances & Appeals Supervisor and work in a remote setup with possible travel for training or meetings....Remote job
$31.25 - $33.65 per hour
...Appeals Specialist Remote GeneDx delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug... ...~ Expertise in appeals process for major insurance plans, Medicaid, and Managed Medicaid. ~ Ability to manage multiple...Remote workWork at officeWork from homeHome officeGeneDx
United States3 days ago- ...Member Appeals Specialist Primary responsibilities would include triaging incoming appeals/grievances, categorizing them appropriately,... ...the turnaround times for these appeals is 30 calendar days (expedited turnaround time is 72 hours, but we start with standard appeals...Remote workTraineeship
Saviance
United States15 hours ago $60.78k
...Appeals And Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances Location... ...with Centers for Medicare and Medicaid Services (CMS), California Department... ..., on weekends, holidays, a hybrid remote schedule, occasional flexibility in...Remote workFull timeLocal areaShift workWeekend workLOS Angeles Care Health Plan
Los Angeles, CA1 day ago$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... ...and eligibility criteria. Experience with Medicaid and Medicare claims denials and appeals...Remote workHourly payFull timeContract workWork experience placementWork at office$51k - $80.07k
The Appeals & Grievances (A&G) unit processes member and non-contracted... ...which include commercial, Medicaid, dual enrollments, Medicare and complete care. Appeals Specialist is the subject matter expert responsible... .... **This position is 100% Remote M-F, 8am-5pm or 8:30pm-5pm EST...Remote workFull timeTemporary workWork experience placement- Job Summary The Medicaid Specialist Field Staff is responsible for overseeing and executing the Medicaid... ...work on‑site Monday through Friday; remote work is not available for this role.... ...upload to EMR. Review denials and file an appeal within 60 days from the date of the...Remote workWork at officeMonday to Friday
- ...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...Remote workWork from home
Point32Health, Inc.
Canton, MA21 hours ago - ...Workday is seeking a Grievance & Appeal Specialist to address appeals within required timeframes and ensure contractual obligations are met... ...Procedures to ensure compliance with regulatory standards. This remote position requires strong communication, confidentiality, and...Remote work
Workday
United States3 days ago - ...A healthcare technology company is seeking a seasoned Revenue Cycle Specialist to manage Medicaid payer accounts and ensure timely reimbursement for healthcare services. This fully remote role involves critical tasks such as claim follow-up and denial resolution, making...Remote work
Medical Guardian
United States1 day 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 workFull timeContract workFor contractorsWork at office
Virtual Vocations Inc
United States4 days ago $30 - $45 per hour
...consulting agency is seeking an Operations Specialist III for a contract opportunity in Long... ..., CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience... ...program metrics. This position is remote and offers a pay range of $30-$45 per hour...Remote workHourly payContract workPyramid Consulting
Long Beach, CA4 days ago- ...and insurance payers to file appeals or facilitate a P2P. Reviews... ...payer guidelines (Medicare, Medicaid, Commercial, etc.) and ensuring... ...clarify coverage requirements to expedite approvals. Work in... ...experience as a Prior Authorization Specialist, with expertise in medical billing...Remote workWork at office
Slocum Center
United States4 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 jobFull timeWork at officeOscar Health
Atlanta, GA8 days ago- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
- ...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, OH2 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, NY1 day ago - Gainwell Technologies is seeking a Provider Enrollment Specialist to support Nevada Medicaid enrollment remotely. The role involves reviewing enrollment, revalidation, and documentation, with outreach to providers to ensure complete submissions and timely approvals. The...Remote job
- Elevance Health in California is seeking an entry-level Analyst in the Enterprise Grievance & Appeals Department to review, analyze and process non-complex grievances and appeals across multiple product types, including HMO, PPO, POS, and others. You will work under guidance...Remote job
- 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
$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 position...Remote jobHourly payContract work- Independence Physician Management (IPM) offers a remote Accounts Receivable Specialist role with a required 3-month in-office training for those within... ...unpaid and underpaid claims, research denials, file appeals, and ensure timely collections across multiple markets....Remote jobWork at office
$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 workFull time$22.74 - $27.79 per hour
...chapter. Discover your story with Adaptive. Position Overview The Appeals Specialist is responsible for managing insurance claim appeals to ensure... ...This job is primarily completing work from a desk. #LI-Remote Compensation Hourly Rate: $22.74 - $27.79 Other...Remote workHourly payWork at officeNight shift- ...submission. Review, approve, and submit every Medicaid Financial Eligibility Application and... ...assure applications are progressing and expedite requests for additional information in... .... Lead response, which may include Appeal, Re-Application, or Acceptance. Recommend...
- ...candidates who have experience navigating Medicaid referrals, submitting service... ...reliable internet connection to facilitate remote workdays; otherwise, working from the office... ...Fundamental Training and Qualified Brain Injury Specialist training are required upon hiring. ·...Remote workFull timeContract workWork at officeLocal areaWork from homeFlexible hoursShift workAfternoon shift
Brain Injury Services, Inc.
Fairfax, VA5 days ago $50k
...treatment team to gather necessary information for concurrent reviews Schedule peer-to-peer reviews and coordinate urgent/expedited appeals Staff individual cases with medical doctors as required Maintain compliance with all standard utilization review policies...Remote workNurseRemotely
United States4 days ago- ...job Job Title: Prior Authorization Specialist Location: Fully remote Duration: 12 months contract Prior Authorization... ...to Coverage Determinations and Appeals Learning Advocates and management... ...: Prior Authorization Medicare and Medicaid Education: High School diploma or...Remote workContract work
Talentify.io
Providence, RI21 hours ago - ...Authorization Coordinator-Field Specialist (PAC Field Specialist) serves... ...daily. Assist in the appeals process for denied re-authorizations... ...escalation workflows when remote outreach efforts have not... ...Medicare Advantage, Commercial, and Medicaid documentation requirements...Remote workWork at officeLocal area
Sleep Management LLC
Little Rock, AR10 days ago $22 per hour
...Insurance Reimbursement Specialist Maven Wise, LLC is recruiting... ...approvals and follow-up with appeals in response to insurance denials... ..., clinics and patients to expedite exchange of required data as... ...completion of in-person training, remote working may be an option.*...Remote workHourly payFull timeContract workTemporary workWork at officeMonday to FridayShift workMaven Wise
Santa Clarita, CA2 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Expedited Medicaid Appeals Specialist. Be the first to apply!
Related searches
- coding specialist Boise, ID
- consulting specialist Boise, ID
- policy specialist Boise, ID
- instructional technology specialist Boise, ID
- community engagement specialist Boise, ID
- ecommerce specialist Boise, ID
- specialist Boise, ID
- credit balance specialist Boise, ID
- resolution specialist Boise, ID
- powerpoint specialist Boise, ID