Remote Grievance Resolution Specialist
Healthfirst
- Remote job
HealthFirst is seeking a Grievance Specialist for the 100% remote Appeals & Grievances team. You will manage member grievances end-to-end, investigate with cross-functional partners, and ensure timely, compliant resolutions within regulatory standards. The role emphasizes advocacy for members and meticulous documentation. Minimum qualifications include a HS Diploma and knowledge of utilization management; preferred candidates hold a Bachelor’s degree and prior managed care experience. #J-18808-Ljbffr HealthFirst
- Healthfirst is seeking a Grievance Specialist to join the Appeals & Grievances team. This remote role handles member grievances across Medicare, Medicaid, CHPlus, SHP... ...CompleteCare with a focus on timely, accurate resolutions. You will research issues across departments,...Remote job
- ...Healthfirst seeks a Grievance Specialist to join the Appeals & Grievances team. This is a 100% remote, non-clinical role focused on resolving member grievances across Medicare... ...vendors, and ensure timely, accurate resolutions in compliance with regulatory standards. #J...Remote work
- ...full life cycle of member and provider appeals and grievance cases, the full-time Appeals and Grievance Specialist will conduct case intake, investigation, and documentation to ensure timely resolution while working remotely. Key responsibilities Research and analyze case...Remote workFull timeWork at office
- ...Healthfirst is seeking a Grievance Specialist for a 100% remote position. You will manage grievances across Medicare, Medicaid, CHPlus, SHP, QHP, EP, and CompleteCare, ensuring timely, compliant resolutions. In this non-clinical role, you will collaborate with internal...Remote work
$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.... ...Duties Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or...Remote workHourly payFull timeContract workWork experience placementWork at office$45.9k - $78.6k
...feels valued. The Appeals & Grievances Specialist III role manages and resolves member complaints... ...case evaluation, prioritization, and resolution. The position contributes to team... ...- 9 AM CT This position is a Remote role. To be eligible for consideration...Remote workWork experience placement- 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
- Foodsmart is seeking a remote Member Support Specialist, Escalations & Grievances to resolve complex, high-priority member issues with empathy and precision.... ...teams, guiding sensitive cases to timely, compliant resolutions. Ideal candidates have 1-3+ years in member...Remote job
- ...Member Advocacy Coordinator to manage ODAG cases from intake to resolution in a remote setting. You will investigate, document, and coordinate... ..., compliant handling of oral dissatisfaction, appeals and grievances. #J-18808-Ljbffr Mass General Brigham Health Plan, Inc.Remote work
- ...plan serving communities across multiple states, seeks a remote Appeals & Grievances Specialist III to manage complex member complaints, grievances,... ...cross-functional teams to ensure timely, accurate resolutions and audit-ready documentation in support of compliant...Remote job
- ...and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with... ...Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related...Remote workFull timeContract workWork at office
$58.9k - $80.07k
The Grievance Specialist is a member of the Appeals & Grievances (A&G) team at Healthfirst and is... ...exclusively on grievance and complaint resolution. The Specialist plays a key role in... ...Location and Hours This position is 100% remote - Schedule M-F, 8am-4:30pm or 8:30am-5...Remote jobContract workTemporary workWork experience placementWork at office$128k - $149.15k
...field of mental healthcare. Rula is a remote-first company. We currently hire in... ...are hiring a Psychiatric Complaints & Grievances Specialist to join our Psych Clinical Quality Team... ..., you'll own the clinical review and resolution of psychiatric complaints and grievances...Remote workFull timeLive inCurrently hiringHome office- ...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
- .... Our partner is looking for a Lead Specialist, Appeals & Grievances based in the United States. As a... ...receive accurate, timely, and compliant resolutions. You will serve as a key resource... ...retirement plans, paid time off, and remote or flexible work arrangements are...Remote workFull timeContract workWork at officeFlexible hours
- ...zilliontechnologies(dot)com // (***) ***-**** Debit Card Dispute Resolution Specialist $25-$27/HR W2 Duration: 6 Months Contract Direct... ...Hybrid Role - 3 Days a week onsite in Pensacola, FL / 2 Days Remote "Work sponsorship is not available for this position....Remote workContract workLocal area3 days per week
- ...zilliontechnologies(dot)com \n \n \n \n Debit Card Dispute Resolution Specialist \n Duration: 6 Months Contract \n Direct Banking... ...Role - 3 Days a week onsite in Pensacola, FL / 2 Days Remote \n \n "Work sponsorship is not available for this position...Remote workContract workLocal area3 days per week
- ...support the collection of past due loans, the full-time hybrid Resolution Specialist will manage member accounts, negotiate repayment options,... ...compliance with regulatory guidelines while working both remotely and in the office. Key responsibilities Collect on all past...Remote workFull timeWork at office
$17 per hour
...Revenue Cycle Management Wizard Flexible hours & work from home remote option Starting salary: $17 AND UP (depending on specific... ...Demonstrate mastery over insurance denials, ensuring prompt resolution and securing payments for all stakeholders Engage in direct...Remote workWork at officeWork from homeFlexible hours- Humana is seeking a Grievances and Appeals Representative 4 within the Internal Review Team to manage denials by reviewing clinical documentation... ...to finalize outcomes, while maintaining high productivity and strict confidentiality in a remote work setup. #J-18808-Ljbffr HumanaRemote job
- Credit Key is seeking an Account Resolution Specialist to independently manage dispute and fraud cases on past-due accounts. You will own investigations... ...with a collaborative team. This position offers a remote work option within the United States, with a focus on accuracy...Remote work
- REVCO SOLUTIONS INC. is seeking an experienced MVA/TPL Resolution Specialist II to independently investigate, negotiate, and resolve complex hospital accounts involving Motor Vehicle Accident and Third-Party Liability claims. You will work with insurers, attorneys, patients...Remote job
- Overlake is seeking a Credit Resolution Representative in Bellevue, WA to research billing and payment postings, notify customers of findings... ...in accordance with department policies. This full-time, remote role requires WA residency. Minimum qualifications include a high...Remote jobFull time
- ...accurate toll and violation reporting. This is a hybrid Phoenix-based position requiring office presence and periodic remote work. The role emphasizes attention to detail, strong organization, and customer service to deliver timely resolutions. #J-18808-Ljbffr PrePassRemote workWork at office
- J&B Medical is seeking a Service Coordinator-Resolution Specialist to support patient care, health insurance, and medical supplies with a focus... ...teams to improve the order process and member experience. Remote work is allowed in specified states; on-site work near Wixom...Remote jobLocal area
- J&B Medical is seeking a Service Coordinator-Resolution Specialist to support escalation handling for patients and leadership, ensuring timely resolutions and quality checks. You will assist the order process from start to finish with cross-functional teams to deliver a...Remote jobFull timeWork at officeMonday to FridayShift work
$27 - $30 per hour
JOB DESCRIPTIONPosition: Medi-Cal Eligibility Resolution SpecialistPay Range: $27.00-$30.00 PER... ...Eligibility Resolution SpecialistWork Type: Remote/OfficePOSITION SUMMARY:The Medi-Cal Eligibility Resolution Specialist is responsible for identifying, resolving, and...Remote workWork at officeLocal area- ...NJ, NV, OK, OR, TN, TX, UT, VA, WA, WI Please note: This is a remote seasonal role, starting in September through December 2026. Do... ...1:1s and on‑camera video huddles to discuss unscripted order resolutions and workflow improvements. Leadership Insight Sharing: Identify...Remote workSeasonal workImmediate startAfternoon shift
- Description HIRING REMOTE IN THE FOLLOWING STATES ONLY: AL, FL, GA, IN, LA,MO, MS, NC,... ...Insurance and Medical Supplies to join our Resolution Team. If you are located within 40 miles... ...The Service Coordinator-Resolution Specialist is responsible for providing support to...Remote workFull timeCasual workWork at officeMonday to FridayAfternoon shift
- ...Join our team and make a positive impact on the lives of others! We are looking for a Case Resolution Specialist I for our team in Pennsylvania. This is a remote role with occasional travel into the FreedomCare hub closest to you. Department & Position...Remote workFull time
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