Remote Appeals Specialist - Precise & Impactful
Lumeris Inc.
- Remote job
Lumeris is seeking an Appeals Coordinator for a remote, United States-based role. You will review, research, and resolve appeals, ensuring compliance with regulations and deadlines. You will handle documentation, communications with members and providers, and prepare case files across the appeals workflow. The position emphasizes accuracy, confidentiality, and professional communication, with opportunities to contribute to process improvements across the department. #J-18808-Ljbffr Lumeris Inc.
$52k - $79.04k
...Appeals Specialist | Tyson & Mendes Are you a detail-oriented billing professional who enjoys solving... ...guidelines, and making a meaningful impact? Tyson & Mendes is looking for an... ...provided here . No recruiters/agencies #li-remote Pay Range $25—$38 USD...Remote workHourly payFull timeWork at office$48.32k - $82.39k
...investigating and tracking member grievances and appeals, and provider claims disputes.... ...lives — and the work you do here makes that impact real every day. You’ll take on meaningful... ..., and a flexible approach to work with remote, hybrid, field or office work schedules....Remote workHourly payFull timePart timeWork at officeFlexible hours- ...Supports the documentation and processing of appeals, disputes and reconsiderations to ensure... ...— and the work you do here makes that impact real every day. You’ll take on meaningful... ..., and a flexible approach to work with remote, hybrid, field or office work schedules....Remote workFull timePart timeH1bWork at officeFlexible hours
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- ...Centers for Medicare and Medicaid Services (CMS). Essential Job Duties • Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or...Remote workFull timeContract workWork at office
- ...Role Title: Consulting Specialist - Executive Presentation Review... ...Contractor Location: Remote (US, UK, CAN, AUS) Engaging... ...to elevate clarity, visual appeal, and impact. # Design compelling... ...refine slide content to ensure precision, consistency, and audience...Remote workContract workFor contractors
- ...seeking a Denials Management Follow Up Representative for a fully remote, full-time position in the United States. You will coordinate... ...for institutional and professional claims, monitor appeals, and analyze performance data to drive improvements. Work closely...Remote workFull time
- ...Supporting the documentation and processing of appeals, the full-time Appeals Specialist II will manage appeals, disputes, and reconsiderations to ensure... ...with state and NCQA requirements while working remotely. Key responsibilities Perform data entry to track, log...Remote workFull timeVisa sponsorshipWork visa
- ...Managing the full life cycle of member and provider appeals and grievance cases, the full-time Appeals and Grievance Specialist will conduct case intake, investigation, and... ...to ensure timely resolution while working remotely. Key responsibilities Research and analyze case...Remote workFull timeWork at office
- ...Leveraging expertise in claims adjudication and risk management, the full-time remote Appeals Specialist will guide clients through the appeals process, ensuring compliance and fair decisions while collaborating with internal teams and mentoring staff. Key responsibilities...Remote workFull timeContract work
$100k - $160k
...environment and positive impact on the community.... ...Description: Senior Biology Specialist TaskUs partners... ...across the pod. Appeals & Policy Enforcement:... ...Truth Labeling: Generate precise, defensible case... ...preferred) Work Setup: Remote Type: Full time...Remote workFull time$60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 900... ...requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in...Remote workFull timeLocal areaShift workWeekend work- CERiS, a division of CorVel Corporation, is seeking an Appeals Representative to handle provider inquiries and appeals via email, fax, telephone, or written correspondence. This is a remote role with strong emphasis on accuracy and timely processing in a compliant environment...Remote jobWork 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 travel...Remote workTemporary workWork at officeLocal area- ...a Work From Home Pledge Drive Donation Specialist in Idabel, OK to support donors with courteous... ...and accurate data entry. This full-time remote position offers flexible hours and the... ...calls, enter donor information precisely, and strive to meet performance targets...Remote jobFull timeWork from homeFlexible hours
- ...applications and next steps. Our partner is looking for a Lead Specialist, Appeals & Grievances based in the United States. As a Lead... ..., healthcare coverage, retirement plans, paid time off, and remote or flexible work arrangements are not provided in the source...Remote workFull timeContract workWork at officeFlexible hours
- 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
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- IVX Health is seeking a Prior Authorization Appeals Specialist to resolve complex pre-service denials and appeals. You will work with providers... ...authorization, denial management, and collaboration in a remote setting, ensuring accurate clinical documentation and streamlined...Remote job
- A-Line is seeking a Remote Appeals Coordinator to support processing of Medicare member and provider appeals and grievances. The role screens for urgency, benefit coverage, and medical necessity, routing cases to the appropriate analyst. Responsibilities include investigations...Remote job
- 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
- Centene Corporation is seeking an Appeals Specialist to support the documentation and processing of appeals, disputes and reconsiderations to meet NCQA requirements. This fully remote role is open to candidates anywhere in the U.S. and follows Eastern Time hours (8:30 AM...Remote job
- Aspirion is seeking a Denials Appeals Specialist to analyze denial reasons, draft and submit appeals, and support improved cash flow. You will... ...experience in healthcare revenue cycle or denial management. Remote work within the United States is allowed. #J-18808-Ljbffr...Remote job
- The University of Texas Southwestern Medical Center is seeking a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers. The role emphasizes follow-up and resolution of denied claims, with no direct billing...Remote job
- Core of the Heart is seeking a remote, part-time clip editor to surface impactful moments from long-form content. You will own the end-to-end clip process, identifying 8-12 moments per stream and delivering timestamps plus topic tags for fast action. You will review every...Remote workPart time
- Lumeris in the United States is seeking an Appeals Coordinator to review, research, and resolve appeals, ensuring compliance with CMS,... ...while maintaining confidentiality and high ethical standards. Remote role with weekends/holidays as needed; includes benefits and potential...Remote jobWeekend work
- Rula is a remote-first company hiring a Senior Paid Search Specialist to drive day-to-day management of a large-scale paid search program across Therapy and Psychiatry... ...a focus on rigorous performance and meaningful impact in a mission-driven health-tech space. #J-18808-...Remote job
$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- Ensemble Health Partners is seeking an Acute Coding Appeals Specialist to remotely handle inpatient DRG denials appeals. You will apply ICD-10-CM/PCS, HCPCS, NCCI, CMS and CMG coding to support accurate billing. Strong documentation and client education are essential....Remote job
- Ensemble Health Partners seeks an experienced Acute Coding Appeals Specialist to review inpatient DRG denials and prepare robust coding appeals... ...to validate codes and improve denials outcomes. The role is remote with occasional on-site travel to client locations. A strong...Remote job
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