Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Claims Appeals & Grievances Specialist

Molina Talent Acquisition

Molina Healthcare is seeking a claims & appeals specialist to support CMS-aligned processes in resolving member and provider concerns. You'll review medical records, assess denials, and communicate timely resolutions to stakeholders. Ideal candidates have 2+ years in managed care, strong customer service, and proficiency with claims systems and Microsoft Office. The role emphasizes regulatory adherence and cross-functional collaboration to meet deadlines. #J-18808-Ljbffr Molina Talent Acquisition

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Claims Appeals & Grievances Specialist in Bothell, WA vacancy
  • JOB DESCRIPTION Job SummaryProvides support for claims activities including reviewing and resolving member and provider complaints...  ...• Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and... 
    Claims
    Contract work
    Work at office

    Molina Healthcare

    Bothell, WA
    3 days ago
  •  ...investigate health plan denials and determine the appropriate action and resolution. Responsibilities include correcting claims, rebilling, and coordinating appeals with payors, while tracking outcomes and identifying denial patterns for process improvements. The role requires... 
    Claims

    EvergreenHealth

    Kirkland, WA
    2 days ago
  • $1,000 - $2,000 per month

     ...You'll Do: The Behavioral Health Specialist (BHS) manages and maintains the safety of...  ...rights under DBHDS and DMAS regulations, grievance process, provides expectations, and...  ...you receive a suspicious communication claiming to represent Connections Health Solutions... 
    Claims
    Hourly pay
    Full time
    Temporary work
    Part time
    Relief
    Immediate start
    Flexible hours
    Shift work
    Night shift
    Weekend work

    Connections Health Solutions

    Kirkland, WA
    8 hours ago
  •  ...• Participates in and maintains the integrity of the appeals process, both internally and externally. • Responsible...  ...corrective actions. • Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. • Attends or... 
    Claims
    Work at office
    Local area

    Molina Healthcare

    Bothell, WA
    2 days ago
  •  ...Medicare, Medicaid, HIPAA compliance, and a fast-paced environment. The position supports the revenue cycle team, handles mail, paper claims, audits, and month-end close tasks. It requires detail-orientation, proficiency with Excel/Word/Outlook, and a commitment to #J-18... 
    Claims
    Contract work

    Kestra Medical Technologies Inc.

    Bellevue, WA
    2 days ago
  • $128.06 per hour

     ...the world. Job Description ~ The Disaster Program Delivery Specialist: • Collects, coordinates and/or reviews applicant data to...  ...needed throughout the program delivery process. • Supports the claims process by reviewing and validating damage details, scopes of work... 
    Claims
    Work experience placement
    H1b
    Immediate start
    Flexible hours

    CDM Smith

    Bellevue, WA
    4 days ago
  •  ...focuses on managing FMLA, STD and LTD processes, serving as the primary client contact, and ensuring timely, accurate handling of claims. Ideal candidates will have an associate or bachelor’s degree, experience in employee benefits or related disciplines, and strong communication... 
    Claims

    USM

    Bellevue, WA
    2 days ago
  • Nintendo in Redmond, WA is seeking a FP&A, Credits, Payments and Fraud analyst to analyze and process claims and manage credit/collections across Nintendo’s third‑party accounts. Minimum three years in dispute resolution is required; Oracle EBS and Microsoft Office proficiency... 
    Claims
    Full time
    Work at office

    Nintendo of America Inc

    Redmond, WA
    2 days ago
  • $19 - $23 per hour

     ...of this job with care before making an application. Intake Specialist (In-Office if Local / Remote if Non-Local) Our mission to change...  ...; 10:00 am - 6:00 pm PST (occasional overtime depending on claim volume) Benefits: ~ Associates working 20+hrs per week: ~... 
    Claims
    Hourly pay
    Full time
    Live in
    Work at office
    Local area
    Remote work
    Monday to Friday

    UNITED WOUND HEALING PS

    Lynnwood, WA
    14 hours ago
  • Swedish Medical Group is seeking a skilled medical billing specialist to support spine and sports medicine services in the Bellevue area....  ...clinicians and billing staff to ensure accurate coding and timely claims, leveraging your clinic experience to maintain high-quality... 
    Claims

    Providence

    Bellevue, WA
    3 days ago
  •  ...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... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    Bothell, WA
    2 days ago
  • A leading training company in claims adjusting is seeking Independent Insurance Claims Adjusters in Kenmore, Washington. The role involves assisting individuals and businesses in recovering from disasters, with support and comprehensive training provided. This opportunity... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    Kenmore, WA
    5 days ago
  • A leading claims adjusting firm in Bothell, Washington is seeking Independent Insurance Claims Adjusters to assist individuals and businesses in recovering from disasters. This role offers the chance for dynamic growth and the opportunity to make a real difference in people... 
    Claims

    MileHigh Adjusters Houston

    Bothell, WA
    2 days ago
  • $175k - $200k

     ...vague or dubious financial schemes, or promote roles that resemble get-rich-quick opportunities. If you receive a suspicious message claiming to be from Nexxen or encounter a questionable job posting associated with our name, please contact us at ****@*****.*** to... 
    Claims
    Full time
    Work at office
    Remote work
    3 days per week

    Nexxen

    Bellevue, WA
    2 days ago
  • $80 per hour

     ...-minutes) Guaranteed payment every two weeks via direct deposit Payment protection for no-shows, late cancellations, & denied claims Why Join Rula? Our dedicated therapist community is made up of thousands of providers across the country, each with diverse backgrounds... 
    Claims
    Hourly pay
    For contractors
    Private practice
    Work at office
    Remote work

    Rula Health

    Kenmore, WA
    1 day ago
  • $65k - $70k

     ...Description Summary Focus Partners is seeking a Referral Channel Specialist. This Specialist partners closely with Business Development...  ...without reasonable accommodations, you may be barred from filing a claim under the provisions of the Workers’ Compensation Act of the... 
    Claims
    Work experience placement
    Internship
    Work at office
    Local area
    Remote work
    2 days per week

    Focus Partners

    Bellevue, WA
    2 days ago
  •  ...Greet patients warmly and manage check-in/check-out Answer phones and respond to patient inquiries Verify and submit insurance claims and pre-authorizations Review EOBs and follow up on outstanding claims Schedule, reschedule, and confirm patient appointments... 
    Claims
    Full time

    Wagner Family Dentistry

    Woodinville, WA
    13 days ago
  • $65k - $80k

     ...customer accounts and update information in the database. Assist customers with policy changes and inquiries. Process insurance claims and follow up with customers on claim status. Coordinate with underwriters to ensure timely policy issuance. Qualifications:... 
    Claims
    For contractors
    Work at office

    David Strasser - State Farm Agent

    Bothell, WA
    5 days ago
  • $46.92k

    Description: Located in Hershey, PA, Milton Hershey School (MHS) is a top-notch home and school where over 2,200 pre-K through 12th grade students from disadvantaged backgrounds are provided an extraordinary, cost-free, career-focused education. This is made possible ...
    Full time
    Work from home
    Relocation package
    Flexible hours
    Weekday work

    Milton Hershey School

    Kirkland, WA
    16 hours ago
  •  ...specialize in defending against all types of General Liability claims. Our team is committed to effectively moving cases through the legal...  ...claims handling through mediation, arbitration, trial, and appeal, we provide comprehensive legal representation tailored to the unique... 
    Claims
    Interim role
    Remote work

    Quintairos Prieto Wood and Boyer PA

    Bellevue, WA
    4 days ago
  • $24 per hour

     ...Job Description Job Description Specialist supports Friends of Youth’s mission by providing trauma-informed, strength-based, and youth-centered support to young adults residing in the Bridge Pointe Program. This 24/7 residential program serves young adults (ages 18... 
    Hourly pay
    Full time
    Work experience placement
    Work at office
    Flexible hours
    Shift work

    Friends of Youth

    Kirkland, WA
    7 days ago
  •  ...— I’ve built this team around service, education, and long-term relationships. My background includes leadership, consulting, and claims, which gives our team a well-rounded understanding of how to properly protect families and support them when they need us most. We... 
    Claims
    Work at office
    Relocation
    Relocation package
    Flexible hours

    Joel Hensel - State Farm Agent

    Bothell, WA
    a month ago
  • $19 - $22 per hour

     ...remind them to return. Resolve customer complaints and damage claims. Employee Supervision and Management The center manager...  ...perform accurate monthly inventory counts Ensure cleanliness and appeal of entire site Maintain safe working environment Maintain... 
    Claims
    Hourly pay
    Local area
    Immediate start
    Flexible hours
    Shift work

    GREASE MONKEY

    Kenmore, WA
    4 days ago
  • $96k - $110k

     ...your ability to perform the essential functions of the job, with or without reasonable accommodations, you may be barred from filing a claim under the provisions of the Workers’ Compensation Act of the State of Rhode Island if the false information is directly related to... 
    Claims
    Work at office
    Local area
    Remote work
    2 days per week

    Focus Financial Partners

    Kirkland, WA
    13 hours ago
  • $132.8k - $219.1k

     ...Imagine loving what you do and where you do it. Job Category Claim, Legal Compensation Overview The annual base salary range...  ...or the company and take cases from inception through trial and appeal. As a Senior Counsel with Travelers you will be responsible for... 
    Claims
    Work at office
    Local area
    Flexible hours

    Travelers Insurance

    Kirkland, WA
    2 days ago
  • $28.5 - $31 per hour

     ...A leading company in the construction materials industry is seeking a Prevailing Wage Specialist to join their team. This is a fantastic opportunity to work with a respected company that values accuracy, compliance, and collaboration. The ideal candidate will bring... 
    Full time
    Local area
    Monday to Friday

    CampusPoint

    Bothell, WA
    1 day ago
  •  ...and employee-focused company that has been moving America's freight safely since 1920. Not all asset-based carriers can make the same claim. We know it's because we're committed to doing things the right way: supporting our drivers, investing in our equipment, and... 
    Claims
    Weekly pay
    Traineeship

    C.R. England

    Bothell, WA
    7 days ago
  • $17.13 - $23.5 per hour

     ...schedule, facility, season, or specific work performed. Multiple premiums may apply if applicable criteria are met. The Parts Specialist will provide all retail and installer customers with a high level of service. This position will also support store management in... 
    Hourly pay
    Minimum wage
    Local area
    Flexible hours

    O'Reilly Automotive Stores

    Woodinville, WA
    5 days ago
  • $48 - $53 per hour

    Responsive recruiter Benefits: Employee discounts Flexible schedule Health insurance Opportunity for advancement Paid time off Training & development Wellness resources Bonus based on performance Registered Nurse...
    Hourly pay
    Full time
    Part time
    Flexible hours
    Weekend work
    Weekday work

    Restore Hyper Wellness

    Kirkland, WA
    4 days ago
  • $500 per month

     ...detail-oriented Business Office & Medical Billing Specialist to ensure efficient, accurate, and timely billing...  ..., and spell‑of‑illness. Submit timely, coded claims to primary and secondary payers and aggressively appeal denials. Coordinate the month‑end "Triple Check"... 
    Claims
    Full time
    Part time
    Work at office
    Monday to Friday
    Flexible hours

    Emerald Heights

    Redmond, WA
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Claims Appeals & Grievances Specialist. Be the first to apply!