Remote Grievance & Appeals Specialist
Banner Health
- Remote job
Banner Health seeks a remote Grievance & Appeals Coordinator in Arizona to support members and providers through the grievance, appeal, and claim-dispute process. This part-time role requires experience with AHCCCS, CMS regulations, and strong communication. You will manage case files in CRM, draft resolution letters, and collaborate with internal teams to ensure timely, compliant responses. Remote work setup preferred; shift is 8:00 a.m.–5:00 p.m. Monday–Friday; candidates must reside in Arizona. #J-18808-Ljbffr Banner Health
- ...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
$45.9k - $78.6k
...quality service is the norm and every member feels valued. The Appeals & Grievances Specialist plays a vital role in ensuring fair, timely, and... ...with Microsoft Word, Excel, and Outlook This position is a Remote role.To be eligible for consideration, candidates must have...Remote workWork experience placement$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. Highly Qualified Candidates Will Have The Following Experience Strong understanding of...Remote workHourly payFull timeContract workWork experience placementWork at office- ...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...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- 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
$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$24.79 per hour
...Trillium Professional is now seeking a Member Appeals Specialist for a 100% remote position! Candidates will work Monday-Friday, 40 hours/... ...-Triage and categorize incoming member appeals and grievances. -Assign and manage appeals from intake through final...Remote workMonday to Friday- ...To support a remote team, the full-time Healthcare Appeals Specialist will analyze, triage, and process complaints and appeals related to dental and vision... ...process standard and escalated appeals, complaints, and grievances from members, providers, and health plans...Remote workFull time
$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- ..., 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...
- ...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
- ...St. Luke's in the United States is seeking a Denials Management Specialist to join our remote team. This role focuses on inpatient CMS denials, medical necessity reviews, and appeals for insurance payers. You will collaborate with Case Management and Billing to improve...Remote work
- ...Working remotely in a full-time capacity, the Appeals Specialist will leverage expertise in claims adjudication and risk management to guide clients through the appeals process, ensuring compliance and effective communication with stakeholders. Key responsibilities Reviews...Remote workFull timeContract work
$20 - $21 per hour
...Appeals Specialist Fully Remote • Allied Benefit Systems Overview Salary Range $20.00 - $21.00 Hourly Position Type Full Time Category Claims Description POSITION SUMMARY: The Appeals Specialist will be responsible for the organization and completion...Remote workHourly payFull timeWork experience placementWork from home$19 - $21 per hour
...Overview: Respond to all assigned levels of denials by submitting appeal letters and required documentation to insurance companies within... ...plan and work with the patient to get the denial overturned. Remote: Although this position is listed as remote, the training period...Remote workHourly pay$248.5k - $373k
.... Growing together.Work at home!You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication...Remote workMinimum wageWork experience placementLocal areaWork from home$19.5 - $21 per hour
...Description We are seeking a detail-oriented and experienced Appeals Specialist for our client in Middleburg Heights, Ohio. In this role, you... ...-$21.00 ~ Monday-Friday 8am-5pm ~3 months in office then remote ~ Benefits offered Key Responsibilities Review...Remote workWork at officeImmediate startMonday to Friday- ...Detail-oriented and analytical, the remote Billing & Appeals Specialist will manage provider billing disputes and appeals, ensuring accurate resolutions while maintaining exceptional customer service in a contract role. Key responsibilities Review, investigate, and resolve...Remote workContract workWork at office
$29.7 - $31.8 per hour
...$31.80 based on experience Job Description The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the performance... ...and improve patient and client experiences. This is a remote position; however, candidates must be willing and able to...Remote workTemporary workWork at officeLocal area$19.43 - $32.98 per hour
...perspective on workplace flexibility. THIS POSITION IS REMOTE/WORK FROM HOME. PREFER APPLICANTS WHO RESIDE IN... ...verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. Gather, analyze and report...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- ...Reference Number: R1050717 Summary We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina. In this role... ...need to work occasional overtime. This role is fully remote or can sit onsite at 26 Century Blvd, Suite ST610 Nashville,...Remote workFull timeContract workFor contractorsWork experience placementSecond jobCurrently hiringWork at officeLocal areaShift work
- Blue Cross Blue Shield of Arizona needs a clinical expert for managing member and provider appeals. This remote position requires strong accuracy, knowledge of compliance timelines, and a focus on customer service. Applicants should possess a healthcare-related degree...Remote job
- ...Job Description Job Description Member Appeals & Grievances Specialist Location: Birmingham, Alabama Work Schedule: This position will primarily work from the VIVA HEALTH headquarters in downtown Birmingham. After training has been completed, there would be...Work at officeImmediate startFlexible hoursWeekend work1 day per week
- ...Job Title Job Description Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established... ...and applying contract and regulatory provisions. This is a Remote Role Experience Experience handling a large load of work in...Remote workContract workApprenticeshipLocal area
$23.22 - $34.84 per hour
A leading health insurance provider is seeking a Grievance & Appeals Coordinator to work virtually full-time, with responsibilities including summarizing complaints, ensuring resolution of grievances, and documenting interactions. The ideal candidate should possess a high...Remote jobHourly payFull time- ...Strategic Staffing Solutions is currently looking for a Grievance & Appeals Coordinator, a W2 contract engagement with one of our largest clients in Detroit, MI! REMOTE!! Title: Grievance & Appeals Coordinator Location : Detroit, MI (Fully Remote) Duration:...Remote workContract work
$22 - $23 per hour
...Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity with long-term potential and is US ( Remote ). Please review the job description below and contact me ASAP if you are interested. Job Diva ID: 26-07046 Pay Range: $22.00 -...Remote workContract workWork at officeLocal areaImmediate start$63.65k - $92.57k
...action, employment terminations (including reduction in force), appeal/grievance process and conflict resolution. Addresses concerns from... ...occasional team meetings at Assembly Row in Somerville, MA. On remote workdays, employees must use a stable, secure, and compliant...Remote workFull timeContract workWork at officeMonday to FridayShift work$83.1k - $120.36k
...Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances... ...compliant manner. The A&G Clinical Specialist is the subject matter expert... ...participating providers. This is either a remote or on-site position located at either...Remote workContract workTemporary workWork experience placementLocal area
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