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

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

Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Senior Appeals & Grievances Specialist (Hybrid Remote) in Los Angeles, CA vacancy
  •  ...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...  ...responding to requests for member and provider appeals, grievances, reconsiderations and corrected claims... 
    Remote work
    Full time
    Contract work
    Work experience placement
    Work at office
    Local area
    1 day per week

    Blue Cross Blue Shield of Arizona

    Phoenix, AZ
    5 days ago
  • $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 work
    Full time
    Local area
    Shift work
    Weekend work

    L.A. Care Health Plan

    Los Angeles, CA
    5 days ago
  •  ...General Hospital is searching for a Senior Denials Specialist for the comprehensive review,...  ...hospital claims through the appeals process. You'll work to ensure...  ...new staff. The position offers a hybrid work model to balance on-site and remote work. #J-18808-Ljbffr Tampa... 
    Remote work
    Senior

    Tampa General Hospital

    Tampa, FL
    1 day ago
  •  ...Branch is seeking a Sr. Patient Account Specialist. This role involves billing all third-party payers and managing appeal processes for denied claims. The...  ...ability to train team members. This is a hybrid position, offering a mix of remote and on-site work in Galveston, Texas... 
    Remote work
    Senior

    The University of Texas Medical Branch

    Galveston, TX
    5 days ago
  • $14.9 - $29.06 per hour

     ...(CMS). Responsibilities Enters denials and requests for appeals into information system and prepares documentation for further...  ...language for letters and prepares responses to member appeals and grievances. Elevates appropriate appeals to the next level for review.... 
    Remote work
    Hourly pay
    Work experience placement
    Work at office
    Weekend work

    Molina Healthcare

    Houston, TX
    3 days ago
  •  ...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 work
    Contract work
    Work at office

    Molina Healthcare

    United States
    9 hours ago
  • $95k - $115k

    Western Health Advantage seeks an Appeals & Grievances Nurse (RN) for their Utilization Management team in Sacramento, CA. This full-time role...  ...3 years of relevant experience. The position allows some hybrid work. Join us to impact healthcare quality and accessibility... 
    Full time

    Western Health Advantage

    Sacramento, CA
    2 days ago
  • 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 job

    Geisinger

    New York, NY
    4 days ago
  • 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

    Geisinger

    New York, NY
    4 days ago
  • $84k - $126k

    Elevance Health is seeking a dedicated professional to investigate member and provider grievances and appeals. This role requires strong problem-solving skills and at least four years of experience in a managed care or healthcare setting, along with a relevant master's... 
    Remote job
    Senior

    Elevance Health

    Las Vegas, NV
    2 days ago
  • Firstsource Solutions Limited is seeking a full-time hourly Remote Customer Service Representative in the United States. The role involves reviewing grievance and appeals documents, classifying disputes, and managing member information in line with HIPAA regulations. The... 
    Remote job
    Hourly pay
    Full time

    Firstsource Solutions Limited

    New York, NY
    2 days ago
  • Elevance Health is seeking a qualified professional for a role in grievance investigations and appeals handling in Denver, Colorado. The position requires a minimum of four years of experience in a managed care or healthcare setting and a current active unrestricted license... 
    Remote job
    Senior

    Elevance Health

    Denver, CO
    1 day ago
  • SHPCA SCAN Health Plan is seeking a Grievances and Appeals Senior Coordinator to support team supervisors and manage member grievances. The role includes...  ...communication skills. This position offers mostly remote work, an annual bonus program, generous PTO, and a robust... 
    Remote job
    Senior

    SHPCA SCAN Health Plan

    Long Beach, NY
    1 day ago
  • $21.78 - $31.52 per hour

    Join Scan-Health-Plan as a Grievances and Appeals Senior Coordinator in Lakewood, California. In this role, you will investigate member grievances...  ...problem-solving skills. Scan-Health-Plan offers a mostly remote work environment with competitive pay ranging from $21.78... 
    Remote job
    Senior
    Hourly pay

    Scan-Health-Plan

    Lakewood, CA
    4 days ago
  • FNBO is seeking an Instant Issuance Senior Specialist in Omaha who will oversee card inventory and printer logistics, and provide...  ...and good problem-solving skills. Work environment is hybrid, with flexibility for remote days, ensuring collaboration and productivity. #J-188... 
    Remote job
    Senior

    FNBO

    Omaha, NE
    2 days ago
  • PowerToFly seeks a Senior Request for Proposal Specialist based in Seattle. This role involves managing RFPs and working...  ...superior communication skills. This is a hybrid role, requiring some in-office presence alongside remote work opportunities. #J-18808-Ljbffr PowerToFly
    Remote work
    Senior
    Work at office

    PowerToFly

    Seattle, WA
    2 days ago
  •  ...Senior Appeals Specialist Job Category: Medical Billing Full-Time Remote Middleburg Heights, OH 44130, USA +1 more locations Description Key Responsibilities: Work as needed in all appeal worklists, potentially with a focus on contracted or sensitive... 
    Remote work
    Senior
    Full time

    Quadax

    United States
    4 days ago
  • Southern California Edison is seeking a Permitting Senior Specialist to join their team in Redlands, California. In this...  ...regulations, and managing project timelines. The position is hybrid, allowing for both in-office and remote work. Ideal candidates should have at least five... 
    Remote work
    Senior
    Work at office

    Edisonrefertalent

    Redlands, CA
    5 days ago
  • Maximus is seeking a Senior Appeals Administrator for their California Independent Medical Review team. This role is vital in ensuring timely resolutions for medical review cases while enhancing the appeals process. The ideal candidate will have an associate degree with... 
    Remote job
    Senior
    Work from home
    Flexible hours

    Wisconsin Psychiatric Association Inc

    New York, NY
    4 days ago
  •  ...Southern California Edison (SCE) as a Land Management, Senior Specialist in Pomona, California. In this role, you will...  ...estate transactions. This position requires traveling and offers a hybrid work mode, combining office and remote work. #J-18808-Ljbffr Edisonrefertalent
    Remote work
    Senior
    Work at office

    Edisonrefertalent

    Pomona, CA
    5 days ago
  • Edisonrefertalent is seeking a Sourcing Senior Specialist to join their team in Pomona, California. In this vital...  ...ideally possess a relevant Bachelor's degree. This hybrid position allows for a combination of in-office and remote work. #J-18808-Ljbffr Edisonrefertalent
    Remote work
    Senior
    Contract work
    Work at office

    Edisonrefertalent

    Pomona, CA
    1 day ago
  • 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 job

    Healthfirst

    New York, NY
    5 days ago
  •  ...communication skills, with extensive experience in watershed-scale planning and hydraulic modeling. This position offers a hybrid schedule allowing up to 40% remote work, along with comprehensive benefits including paid overtime and an annual performance bonus. A Bachelor’s... 
    Remote job
    Senior

    Freese and Nichols, Inc.

    Fort Worth, TX
    5 days ago
  •  ...Forman in Louisville, Kentucky is seeking a Senior People Systems Specialist with expertise in Workday integrations....  ...analytical skills. The position includes a hybrid working model, with 4 days in-office and Fridays available for remote work. #J-18808-Ljbffr Brown-Forman
    Remote job
    Senior
    Work at office

    Brown-Forman

    Louisville, KY
    1 day ago
  • Qiagen N.V is looking for a Senior Sales Application Specialist for HID & Forensics in Germantown, MD, responsible for providing tailored HID solutions...  ..., including key laboratory techniques. Qiagen offers a hybrid work model and comprehensive benefits. #J-18808-Ljbffr... 
    Remote job
    Senior
    Full time

    Qiagen N.V

    Germantown, MD
    5 days ago
  • L.A. Care Health Plan is seeking an Appeals and Grievances Nurse Specialist RN II to assist members with health care access and benefit coordination...  ...RN role and a nursing degree. This position offers a hybrid remote schedule and includes various benefits such as Paid Time... 
    Remote job

    L.A. Care Health Plan

    Los Angeles, CA
    5 days ago
  • The Robert Joseph Group is seeking a Senior GL Accountant to join their team in Maryland. This role offers a hybrid work environment combining remote and in-office work, providing flexibility and work-life balance. As a Senior GL Accountant, you will be responsible for... 
    Remote work
    Senior
    Work at office

    6AM City, LLC

    Annapolis, MD
    5 days ago
  •  ...Media Agency in Dallas is seeking a full-time Senior Public Relations Specialist. The ideal candidate will have 4-5 years of...  .... The position offers competitive pay, benefits, and a hybrid work schedule allowing for both office and remote work. #J-18808-Ljbffr Championmgt
    Remote work
    Senior
    Full time
    Work at office

    Championmgt

    Dallas, TX
    3 days ago
  •  ...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 work
    Senior
    Full time
    Work experience placement
    Second job
    Work at office
    Monday to Friday
    Shift work

    SMPS Charlotte

    Columbia, SC
    1 day ago
  • Elios AI is seeking a Senior Endur Specialist in Houston, TX for a full-time position. This role includes configuring Openlink Endur...  ...market experience is crucial for success. The role offers a hybrid work model, balancing remote and onsite tasks. #J-18808-Ljbffr Elios AI
    Remote work
    Senior
    Full time

    Elios AI

    Houston, TX
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Senior Appeals & Grievances Specialist (Hybrid Remote). Be the first to apply!