Senior Appeals & Grievances Specialist (Hybrid Remote)
L.A. Care Health Plan
L.A. Care Health Plan is seeking an Appeals and Grievances Specialist II in Los Angeles, CA. The role involves investigating member and provider complaints, ensuring compliance with various health regulations, and preparing reports. Requirements include at least 2 years in Managed Care, knowledge of medical terminology, and excellent communication skills. This full-time position offers a hybrid work schedule and a comprehensive benefits package including medical, dental, vision, and PTO. #J-18808-Ljbffr
- ...health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability,... ...are classified as hybrid, onsite or remote. While the majority of our employees are... ...responding to requests for member and provider appeals, grievances, reconsiderations and corrected claims...Remote workFull timeContract workWork experience placementWork at officeLocal area1 day per week
$60.78k
Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition... ...position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in...Remote workFull timeLocal areaShift workWeekend work- ...Geisinger is seeking a dedicated professional to support the administration of the Appeals and Grievance process. The role involves acting as a liaison between members and the Plan regarding denied claims, services, and other concerns. Responsibilities include managing...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.... ...experience, education and/or skill level. Seniority level Entry level Employment type...Remote workHourly payFull timeContract workWork experience placementWork at office- Geisinger is looking for a professional to provide support in the administration of the Appeals and Grievance process. This role involves liaising between members and the plan to address denied claims and benefit issues. Applicants should have a minimum of 5 years of relevant...Remote job
- 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
- ...Senior Proposal Specialist - Hybrid, Columbia, SC BlueCross BlueShield of South Carolina Job Posting Apr. 27, 2026 Job Description Summary This high... ...environment. The position is hybrid, 3 days in office, 2 days remote. You will work an 8-hour shift scheduled during our...Remote workSeniorFull timeWork experience placementSecond jobWork at officeMonday to FridayShift work
$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 workHourly payWork at office$24.41 - $34.18 per hour
...HealthCare seeks to hire an experienced Senior Revenue Cycle Specialist for our Ambulatory department who... ...insurance companies regarding the status of appeals. • Daily reconciliation and... ...Friday Shift Type: Day Shift - Hybrid Schedule Holiday Requirements:...SeniorDaily paidFull timeTemporary workWork at officeMonday to FridayFlexible hoursShift workDay shift- An IT consulting firm in Columbus, Ohio, seeks a Senior Technical Specialist 4. This role involves leading enterprise application development... .... The position provides H-1B visa sponsorship and a hybrid work model, appealing to IT professionals looking to advance their careers...SeniorH1bVisa sponsorship
$40 - $100 per hour
...Senior UAS Pilot / Geomatics Specialist (Part-Time) Tetra Tech is adding a Senior UAS Pilot / Geomatics Specialist (Part-Time) to support our Geomatics... ..., and assisting project teams with aerial survey and remote sensing activities. The successful candidate will...Remote workSeniorHourly payContract workPart timeFor contractorsWork experience placementWork at officeLocal areaWorldwideFlexible hours- ...quality, competitive proposals. As the Senior Proposal Specialist, you will play a pivotal role in... ...through exceptional writing and visually appealing submissions that differentiate us... ...) profit-sharing retirement plan Hybrid or remote work possible for the right...Remote workSeniorWork at office
$48.6k - $83.16k
...Responsible for processing expedited appeals: those that are complex in nature, require... ...times of the Expedited Appeal unit, the Specialists are required to work weekends and holidays... ...versed in all aspects of the complaint, grievance and appeal process and be able to...Remote workHourly payContract workWeekend work$18 - $24 per hour
...Pay Rate: $18 to $24 per hour Summary: ~ Work Mode: Remote Responsibilities: Triage incoming appeals and grievances, categorize them appropriately, and assign them to the team. Make outbound calls when necessary and check voicemails. Respond...Remote workHourly pay$24.79 per hour
...Member Appeals Specialist Trillium Professional is now seeking a Member Appeals Specialist for a 100% remote position! Candidates will work Monday-Friday, 40 hours/week for about... ...incoming member appeals and grievances. Assign and manage appeals from intake...Remote workWork at officeMonday to Friday$8.63k - $11.56k
...California residency. This position offers hybrid telework opportunities; however,... ...Specification. ~ INFORMATION TECHNOLOGY SPECIALIST II Additional Documents Job... ...withheld from an eligibility list may file an appeal with the State Personnel Board....Remote workPermanent employmentFull timePart timeWork at officeRelocationMonday to FridayShift work- ...solutions provider is seeking a Sr. VNDLY/Workday HRIS Specialist for a contract assignment in Atlanta, GA. The role... ...ability to work effectively in teams. This position allows remote work initially and transitions to hybrid if it becomes full-time. #J-18808-Ljbffr...Remote workSeniorFull timeContract work
$50k - $55k
.... Under the direction of the Appeals Department leaders, the Appeals... ...the department. The Appeals Specialist level II performs research,... ...investigation, and analysis of appeals, grievances, and other types of... ...atmosphere of frequent interruptions Remote Work Requirements High speed...Remote work$45.9k - $78.6k
...a community of connected care, where coordinated, quality service is the norm and every member feels valued. Medica’s Appeals and Grievance Specialist plays a vital role in ensuring our members and providers receive clear, timely, and accurate resolutions to their concerns...Work experience placementWork at office3 days per week- ...Appeals and Grievance Specialist II (Managed Care) – Irving, TX | 12-Week Contract Location: Irving, TX Job Type: 12-Week Contract Company: Sigma Inc. Schedule: Monday–Friday | 8-Hour Shifts Join Our Team as an Appeals and Grievance Specialist II! Sigma Inc....Contract workMonday to FridayShift work
$32 - $33 per hour
...Appeals and Grievance Specialist Job details Posted 17 July 2026 Location Irving, TX Reference 1011652 Job description Appeals and Grievance Specialist II Location: Irving, TX 75039 Pay range: $32-33/hr Schedule: Monday...Contract workWorldwideMonday to Friday$130k - $160k
...Job Description Job Description Senior Fullstack Engineer (Team Builder & Full-Stack Specialist) Stack: JavaScript (Node/Lambdas),... ...and foster a sense of community. Hybrid: For those who prefer a balance between office and remote work, we offer a hybrid model. This...Remote workSeniorFor contractorsWork at officeLocal areaFlexible hours- ...Appeals & Grievance Specialist Schedule Monday – Friday Onsite Position Position Summary The Appeals & Grievance Specialist II is responsible for independently researching, reviewing, and resolving member and provider inquiries, complaints, appeals, and grievances. This...Work at officeMonday to Friday
- ..., member and provider complaints, and reconsideration and redetermination requests. Review and respond to complaints, grievances and appeals within the stated time frame for each request Certify that providers and members are reimbursed accordingly using Medicare...
$107.7k - $199.3k
...across all teams, providing quality assurance and coaching to Senior Business Process Consultants. ~Ensures that all approved business... ...time off plus holidays. ~Flexible approach to work with remote, hybrid, field, or office work schedules. Actual pay will be...Remote workSeniorFull timePart timeWork at officeFlexible hours$23.34 - $35.01 per hour
...high level of service. Process agency brokerage shipments. Handle remote filings. Perform entry reconciliations as needed. Ensure all... ...Additional Details M/F 7:30 am – 4:00 pm and T/W/T 8:00 am – 4:30 pm, Hybrid. Benefits The Company offers eligible employees health, vision...Remote workSeniorHourly payContract workWork at office$75.35k - $98.89k
...Hi, we’re Oscar. We’re hiring a Senior Learning Specialist to join our Decentralized Learning team. Oscar... ...our New York City office, requiring a hybrid work schedule with 3 days of in-office... ...engagement from both in‑person and remote learners Collaborate with subject‑matter...Remote workSeniorWork at officeFlexible hours$246.1k - $344.2k
...decisions on complex appeal cases, exercising professional... ...address and resolve grievances and appeals.... ...Hospitalist clinical specialists Work at Home Requirements... ...profiles. This is a remote position anywhere in... ...Requirements: To ensure Home or Hybrid Home/Office employees'...Remote workFull timeTemporary workFor contractorsApprenticeshipInterim roleWork at officeWork from homeHome officeMonday to Friday- ...mobility services provider in California is seeking a motivated Senior Associate to join their Global Compensation and Payroll... ...full-time position offers the chance to work in a dynamic environment. This role can be hybrid or remote based on location. #J-18808-Ljbffr...Remote workSeniorFull time
- ...The Senior Specialist, Benefits plays a key role in managing and enhancing the organization’s employee benefits programs... ...and sufficient lighting, ergonomic desk/chairs. Hybrid work schedule (Combination of in-office and remote). Lifting 25 lbs. Your Performance Will Be...Remote workSeniorContract workWork at office
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