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
- JOB DESCRIPTION Job Summary Provides 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...ClaimsContract workWork at office
- Northwest Administrators, Inc. is seeking an Appeals Specialist to support the Health and Welfare Claims Department, focusing on member disputes and appeals. You will review and process appeals, analyze claims and plan descriptions, collaborate with internal teams to prepare...ClaimsWork at office3 days per week
$30.7 - $41.54 per hour
What you'll be doing... The Appeals Specialist will assist in the operations of the Health and Welfare Claims Department and will primarily focus on member disputes and appeals. Review and process member and provider appeals, ensuring accuracy and adherence to policies...ClaimsHourly payWork at officeLocal area3 days per week- ...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
$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...ClaimsHourly payFull timeTemporary workPart timeReliefImmediate startFlexible hoursShift workNight shiftWeekend work- Northwest Administrators, Inc. is seeking an Appeals Specialist to assist in the Health and Welfare Claims Department, focusing on member disputes and appeals. Responsibilities include reviewing appeals, analyzing claims and contracts, collaborating with internal teams,...ClaimsWork at office
- ...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
- Symetra in Bellevue, WA is seeking a Disability Intake Specialist WBI to support our call center with timely, accurate claim information and empathetic service. You will gather information to perfect claims and document activity in the claim system. Ideal candidates have...ClaimsRemote jobFull timeFlexible hours
- 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...ClaimsFull timeWork at office
$22 - $33.95 per hour
...thrilling chance to become part of our team as a Disability Intake Specialist WBI ! About the role As a Disability Intake Specialist you... ...to the call center with timely, accurate, and customer-focused claim information, gathering information needed to perfect the claim,...ClaimsHourly payFull timeContract workImmediate startRemote workWork from homeVisa sponsorshipWork visaFlexible hours$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...ClaimsHourly payFor contractorsPrivate practiceWork at officeRemote work- 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
- 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...ClaimsFlexible hours
$74.63k - $93.32k
AirReps is seeking a professional individual for our Project Specialist 2 position with our organization at our location in Bellevue, Washington... ...manufacturers and clients in processing warranty and freight claims. Identify and proactively resolve potential issues related to...ClaimsFull timeFor contractorsWork experience placementFlexible hours$22 - $24 per hour
...Leasing Specialist Avanath is proud to be named one of the top property management companies to provide affordable housing for the workforce... ...Supervisor. Contribute to the cleanliness and curb appeal of the community on a continuing basis. Assist in planning resident...Immediate startFlexible hoursAfternoon shift$80 per hour
...hourly session * 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...ClaimsHourly payFor contractorsPrivate practiceWork at officeRemote work- ...Job Overview: We are currently seeking skilled and dedicated individuals to join our team as a Cargo Specialist. As a Cargo Specialist, you'll ensure the Army receives supplies, weapons, and equipment daily all over the world. You will be trained in cargo documentation...Part timeImmediate startRelocation packageFlexible hours
- 68W Combat Medic Specialist Job Overview: Jumpstart your medical career! As an Army Medic, you are the front line in delivering life-saving emergency medical services to individuals in need. This dynamic and challenging position requires quick thinking, compassion...Full timeContract workPart timeImmediate startRelocation packageFlexible hours
$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...ClaimsFull timeWork at officeRemote work3 days per week- ...Job Overview: We are currently seeking skilled and dedicated individuals to join our team as a Cargo Specialist. As a Cargo Specialist, you'll ensure the Army receives supplies, weapons, and equipment daily all over the world. You will be trained in cargo documentation...Part timeImmediate startRelocation packageFlexible hours
- ...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...ClaimsInterim roleRemote work
$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...ClaimsHourly payLocal areaImmediate startFlexible hoursShift work- Overview Job Title: Associate Specialist, Production Planning and Scheduling Location: Bothell, WA Top Skills ERP experience Experience in GMP or regulated environment Strong computer skills with Microsoft Office Strong communication skills both written and oral Knowledge...Work at office
- ...developing the technologies to make this possible, with the ultimate goal of enabling human life on Mars.SHIPPING SPECIALISTAs a Shipping Specialist, you will be responsible for the expedient movement of designated items needed to support production, test, and launch operations...Permanent employmentTemporary workWork at officeMonday to FridayAll shiftsShift work
$21.5 - $25.5 per hour
...What You’ll Do Position Summary: The Mental Health Technician/Behavioral Health Specialist (BHS) plays a vital, hands‑on role in shaping the daily experience of adolescent and young adult patients in Newport Healthcare’s behavioral health programs. As a frontline...Hourly payWork experience placementShift workNight shiftAfternoon shift$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...ClaimsHourly payFor contractorsPrivate practiceWork at officeRemote work$136.1k - $224.5k
...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...ClaimsWork at officeLocal areaFlexible hours$80 per hour
...hourly session * 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...ClaimsHourly payFor contractorsPrivate practiceWork at officeRemote work$48 - $53 per hour
Benefits: Employee discounts Flexible schedule Health insurance Opportunity for advancement Paid time off Training & development Wellness resources Bonus based on performance Registered Nurse Role Overview The ideal Restore Registered Nurse...Full timePart timeFlexible hoursWeekend workWeekday work- Job DescriptionPosition Purpose:The Asset Protection Specialist is primarily responsible for preventing financial loss caused by theft and fraud and supporting safety and environmental program compliance in their assigned store/multiple stores. They
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