Claims Appeals & Grievances Specialist
Molina Healthcare
A health care organization is seeking a Specialist, Appeals & Grievances to support claims activities by resolving member and provider complaints. The ideal candidate will have at least 2 years of managed care experience and a strong understanding of health claims processing. Responsibilities include conducting research on grievances, meeting department standards, and communicating resolutions. A competitive hourly wage and benefits are offered. This role is full-time and entry-level, suitable for motivated individuals ready to contribute to a vital healthcare mission. #J-18808-Ljbffr Molina Healthcare
$24 - $26 per hour
...Responsibilities Follow up on outstanding insurance claims and patient accounts to ensure full... ...denied or rejected claims by initiating appeals or resubmitting corrected claims.... ...today and one of our healthcare recruiting specialists will be in touch! #J-18808-Ljbffr...ClaimsWeekly payContract workMonday to Friday- ...Revenue Cycle Operations, the Revenue Cycle Specialist participates in all aspects of insurance... ...of timely filing deadlines, payer appeals, and researching payer policies. Manage... ...as needed to resolve denials and pending claims. Generate patient correspondence to be transmitted...ClaimsWork at office
$24 - $33 per hour
...Twitter) and Facebook. Position Summary As a Reimbursement Specialist II, Follow Up & Appeals, you will play a vital role in ensuring the financial... ...Responsibilities Track, report, and resolve complex outstanding claims. Troubleshoot Explanation of Benefits (EOBs) and identify...ClaimsWork experience placementWork at officeRemote workWork from home- Sedgwick is seeking a LTD Case Specialist (Hourly) in West Hills, CA. You will analyze claims to determine benefits due, assess need for outside vendors or medical evaluations, and negotiate settlements within authority. You will also process payments and revisions to...ClaimsHourly pay
- A leading insurance firm is looking for a Claims Investigator to support the loss investigation process. The role includes conducting thorough on-site investigations of claims, documenting details, and preparing reports under direct supervision. Candidates should have...Claims
$70.4k - $92k
...experiencing tremendous growth and success. Your Next Opportunity The HSE Specialist I is an entry‑level professional safety position. It is a field... ...risks and control measures. Support incident, near‑miss, and claim investigations and communications. Maintain working knowledge...ClaimsFull timeFor contractorsWork at officeLocal areaFlexible hours- ...to appropriate accounts. Scan refund payment copies and check against patient accounts. Request approval for write-offs of unpaid claims with no re-bill capabilities, escalating issues as needed. Identify and resolve payment posting issues. Maintain current knowledge...ClaimsWork experience placementWork at officeLocal area
$26.55 - $30 per hour
## LTD Case Specialist (Hourly)Applylocations: West Hills, CAtime type: Full timeposted on: Posted Todayjob requisition id: R76586By joining... ...Case Specialist (Hourly)**PRIMARY PURPOSE****:** To analyze claims and determine benefits due ensuring compliance with plan provisions...ClaimsHourly payWork at officeLocal areaFlexible hours- ...Printed check orders Branch cash ordering and shipping (as applicable) Branch Certifications (as assigned) Stop payments Holds Reg. E Claims Safe Deposit Box opening, closing and servicing (as assigned) Demonstrated proficiency and understanding of all compliance...ClaimsWork experience placementWork at office
$75k - $165k
...requirements This role will be filled at either the Underwriting Specialist or Executive Underwriter level. The hiring manager will... ...Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support area OR Zurich Certified Insurance Apprentice...ClaimsContract workTemporary workApprenticeshipWork at officeLocal area- ...qualified individuals interested in the Public Health Program Specialist II position. There is currently one (1) vacancy in the Public Health... ...and logically evaluating information, propositions, and claims Delivering Results : Meeting organizational goals and customer...ClaimsPermanent employmentFull timeWork at officeRemote work
- ...responsive client service, aggressive file management, and practical claim resolution. Our team works closely with employers, carriers,... ..., depositions, and other proceedings as needed. Manage cases on appeal and work within applicable judicial and procedural requirements....ClaimsRemote workFlexible hours
$75k - $165k
Zurich is seeking an experienced Underwriting Specialist or Executive Underwriter, Construction PL to join our Specialties Construction team... ...Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support area OR Zurich Certified Insurance...ClaimsFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workVisa sponsorship$14.9 - $29.06 per hour
...member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials. Knowledge / Skills /...Hourly payWork experience placement- VitalConnect, Inc. is seeking a Denial Management Specialist on a fully remote basis to join the Revenue Cycle team. You will investigate complex third-party insurance denials and optimize reimbursement by researching and acting quickly on denials. The role requires 3+...Remote job
$150k - $175k
...Company Goodman Neuman Hamilton LLP (GNH) is a civil litigation and appeals firm based in San Francisco with 14 attorneys. The firm... ...organization, and jury instructions Communicate regularly with clients, claims professionals, experts, and opposing counsel Collaborate with...ClaimsFull time- ...a deep understanding of the end-to-end billing cycle, including claim submission, payment posting, accounts receivable (A/R), and denial... ...Conduct denial management and follow-ups , including appeals and resubmissions Perform insurance verification and eligibility...ClaimsPermanent employmentRemote work
- ...accomplished litigation team. State Compensation Insurance Fund Claims Legal Department is hiring multiple Attorney and Attorney III... ...litigate in multiple varied venues of the Workers’ Compensation Appeals Board. Engage in special projects, provide training, or manage...ClaimsWork at office
- ...A leading claims adjusting company in California is seeking Independent Insurance Claims Adjusters to join their team. This is a dynamic career opportunity where you will help individuals and businesses recover from disasters. Whether you are an experienced adjuster or...ClaimsFlexible hours
- ...revenue. Key responsibilities include processing and submitting claims to insurance companies and patients, following up on unpaid... ...reasons and perform the necessary follow-up actions including appealing denied claims with appropriate documentation and justification....ClaimsFlexible hours
- ...Representative in Santa Rosa, CA. The role will determine claimant eligibility for SDI benefits, conduct fact-finding interviews, process claims, and ensure accurate customer service, with hybrid telework options and standard M-F schedule. Ideal candidates will understand SDI...ClaimsRemote work
- A leading claims adjusting firm is seeking Licensed Insurance Claims Adjusters in California, MO. The role involves aiding individuals and businesses in recovering from disasters while enjoying flexible working conditions. Candidates will receive comprehensive training...ClaimsFlexible hours
- A leading insurance claims organization is seeking Independent Insurance Claims Adjusters in California, MO. This role offers the chance to make a significant impact on clients' lives while enjoying a flexible career path and competitive compensation. Candidates should...ClaimsFlexible hours
- A national insurance adjuster company is seeking Independent Insurance Claims Adjusters to join their team in California, MO. This role offers a dynamic career path with flexibility and competitive compensation. The company provides comprehensive training to equip new...ClaimsFlexible hours
- A leading insurance claims adjusting company in Missouri seeks Independent Insurance Claims Adjusters. This role is vital in aiding recovery efforts for clients affected by disasters, providing a rewarding career with flexibility and competitive compensation. You will...Claims
- MileHigh Adjusters Houston is looking to hire an Independent Insurance Claims Adjuster in California, United States. This position offers flexibility, autonomy, and competitive compensation. The demand for claims adjusters is rising due to storm-related events, and licensed...ClaimsFlexible hours
- Stance Health Solutions is seeking a Revenue Cycle Auditor to manage the revenue cycle, submit and follow up on insurance claims, and resolve payer discrepancies. The role involves analyzing accounts receivable, identifying denial patterns, and coordinating with providers...Claims
- ...IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth...Claims
- ...adjusting experience is required for career-entry applicants. Are you interested in building a career as an Independent Insurance Claims Adjuster? With continued storm activity and catastrophic weather events across the country, experienced and properly trained adjusters...ClaimsFlexible hours
- A claims adjusting company is looking for Independent Insurance Claims Adjusters in California. This role offers the opportunity to make a positive impact in people's lives by assisting with recovery from disasters. Ideal candidates will be licensed adjusters or willing...ClaimsFlexible hours
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