Remote PA: Appeals & Grievances Specialist
Sustainable World, Inc.
- Remote job
UnitedHealthcare offers a remote-friendly physician assistant role across the United States, focusing on review and adjudication of appeals and grievances. You will collaborate with medical directors and an integrated team to assess medical necessity and benefit design. The position requires PA licensure, NCCPA certification, and 5+ years of clinical experience, with strong MS Office skills and weekday hours. A comprehensive benefits package supports your growth. #J-18808-Ljbffr Sustainable World, Inc.
$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- 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
$14.9 - $29.06 per hour
...(CMS). Essential Job Duties 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....SuggestedHourly payWork experience placementWork at office- Our client is seeking an experienced Grievance and Appeals Specialist with strong health plan industry experience to join their team. The Grievance and Appeals Specialist is responsible for reviewing, investigating, and resolving member and provider grievances and appeals...Suggested
- ...Grievance & Appeals Coordinator Are you an analytical problem solver with a passion for healthcare managed care? We are seeking dedicated... ...Coordinators to join our growing, collaborative team! In this fully remote role, you will analyze and resolve complex member and...Remote workWork from homeHome officeWeekend work
$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- ...General Brigham Health Plan is seeking an Appeals Coordinator to coordinate, process,... ...and ensuring regulatory compliance in a remote environment within the United States. Ideal... ...will have 3-5 years in health plan appeals/grievances, strong customer service, and excellent...Remote job
- ...Appeals and Grievance Specialist II (Managed Care) – Irving, TX | 12-Week ContractLocation: Irving, TX Job Type: 12-Week Contract Company: Sigma Inc. Schedule: Monday–Friday | 8-Hour ShiftsJoin Our Team as an Appeals and Grievance Specialist II!Sigma Inc. is seeking an...Contract workMonday to Friday
$225k - $300k
...certified Pediatric Nurse Practitioner (PNP) or PA or MD or DO OR General Pediatrician OR... ...pediatric care with both in-person and remote services, giving our team members... ...and procedures Facilitate referrals to specialists and medical facilities as necessary Collaborate...Remote workDaily paidFull timePart timeRelocation packageMonday to FridayFlexible hoursShift work- UnitedHealthcare is hiring a Physician Assistant/Associate to join the appeals and grievances team. You will adjudicate cases with medical directors and... ...plans such as PPO, HMO, MAPD, and PDP. The role requires a PA license, NCCPA certification, and at least five years of...Remote job
- ...Physician Assistant/Associate to oversee appeals and grievances with a multidisciplinary team. You will... ...outcomes. Required is an active PA license, NCCPA certification, and 5+ years... ...practice, plus strong MS Office skills. This remote role supports US-based work hours and...Remote job
- ...Health Services team to ensure proper processing of member grievances, provider appeals, and state fair hearings. You will serve as the primary contact... ...law, plus leadership experience managing cross-functional teams on large projects. #J-18808-Ljbffr PA Health & WellnessRemote job
- MJHS seeks an A&G Specialist in New York, NY to handle department correspondence, log and route mail, and provide back-up support... ...and the director. The role emphasizes timely processing of grievances and appeals within regulatory timeframes. Responsibilities include opening...
$23.63 - $33.09 per hour
Our Grievance & Appeals Specialist I act as the primary investigator for member appeals and grievances including analyzing, researching, and managing inventories. Responding to member/provider requests within regulatory requirements and plan policy. We're looking for Grievance...Contract workTemporary workLocal area- UnitedHealth Group, through OptumCare, seeks a qualified professional to manage Medicare reconsiderations, grievances, and appeals, coordinating with CMS and internal stakeholders. You will help ensure CMS regulatory compliance and drive timely resolutions. The role requires...
- SafeRide Health in San Antonio, TX seeks an experienced Complaints and Grievance Coordinator to process member grievances, appeals, and provider disputes in alignment with client requirements across lines of business. You will document cases, maintain timelines, communicate...
- 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
$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 workMinimum wageWork experience placementLocal areaWork 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
- ...special project research as assigned Interact professionally with PA staff to provide timely responses Respond to inquiries within... ...due dates Company Benefits & Culture: Flexible remote working options for local candidates No vaccination mandate required...Remote workContract workWork experience placementLocal areaFlexible hours
$19.76 per hour
...managed care professional looking for an exciting work-from-home opportunity in Iowa? We are seeking a self-motivated, organized Grievance & Appeals Coordinator to join our dynamic team! In this essential role, you will review incoming complaints, investigate complex...Remote workHourly payPermanent employmentTemporary workWork experience placementWork at officeWork from homeHome officeMonday to FridayShift workWeekend work- 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
$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...Remote workTemporary workWork at officeLocal area$19.5 - $21 per hour
...Description We are seeking a detail-oriented and experienced Appeals Specialist for our client in Middleburg Heights, Ohio. In this role, you... ...-$21.00 ~ Monday-Friday 8am-5pm ~3 months in office then remote ~ Benefits offered Key Responsibilities Review...Remote workWork at officeImmediate startMonday to Friday- ...Incorporated (LHI), part of the Optum family, seeks PAs or NPs for a fully remote, virtual health role delivering clinical care across multiple... ...guidelines. Required qualifications include a Master's in PA or NP, valid unrestricted license, and experience in clinical settings...Remote jobContract work
- ...medicine diagnostics, is seeking an Insurance Reimbursement Specialist to maximize collections by pursuing unpaid claims and managing multi-level appeals. This full-time role is based in Brisbane, CA, with some remote collaboration for eligible candidates. You will work...Remote jobFull time
- American Oncology Network, LLC in Houston, TX seeks a qualified APRN/PA to provide high-quality virtual oncology care. This full-time role offers remote work with travel 0-25% as needed. You will conduct virtual visits, coordinate care, prescribe within scope, and participate...Remote workFull time
- ...Virtual Health Assessment role supporting Oscar Health members remotely across multiple states. You will engage patients via virtual visits... ...and virtual primary care as needed. The position requires NP/PA credentials, board certification, multi-state licensure, and 3+...Remote job
- Guardant Health seeks a Reimbursement Specialist II, Follow-Up and Appeals to join the revenue cycle team. You will analyze EOBs, appeal denials, and manage payer communications, all while supporting patient financial services and process improvements. Responsibilities...Remote job
- ...Wayne Integrated Health Network is seeking a Customer Service Grievance Specialist to ensure compliant management of grievances under local,... ...analysis, and training modules for staff and contractors, with remote work available and supervision required. #J-18808-Ljbffr...Remote jobFor contractorsLocal area
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