Grievance & Appeals Analyst I — Remote
Elevance Health
- Remote job
Elevance Health is seeking a Grievance/Appeals Analyst I to join the Enterprise Grievance & Appeals Department. This entry level role reviews, analyzes and processes non-complex grievances and appeals from diverse customer types across multiple products, focusing on quality of service and care issues. You will follow URAC/NCQA standards, prepare written determinations, and collaborate with nursing, medical staff, and other internal teams. #J-18808-Ljbffr Elevance Health
- ...Position: Business Analyst III - Appeals & Grievances Location: Los Angeles, CA, US (Remote) Duration: Permanent Job Description: The Business Analyst III facilitates business process improvement via the methodical investigation, analysis, review...Remote workPermanent employmentWork at office
- ...Grievance & Appeals Coordinator Are you a detail-oriented managed care professional looking for an exciting work-from-home opportunity in Iowa? We are seeking a self-motivated, organized Grievance & Appeals Coordinator to join our dynamic team! In this essential role...Remote workWork from home
- ...Grievance & Appeals CoordinatorAre you an analytical problem solver with a passion for healthcare managed care? We are seeking dedicated Grievance... ...to join our growing, collaborative team! In this fully remote role, you will analyze and resolve complex member and...Remote workWork from homeHome officeWeekend work
- Position Summary The Grievance and Appeals Analyst I is responsible for the review, investigation, and resolution of member grievances and appeals within a managed‑care health plan. The analyst ensures all activities are conducted in compliance with regulatory requirements...SuggestedContract workWork at office
- Solis Health Plans is hiring for the Grievance and Appeals Analyst I position based in New York. This role involves reviewing member grievances and appeals, ensuring compliance with CMS and NCQA guidelines. Ideal candidates will have at least 2 years of experience in managed...SuggestedWork at office
- Natera is seeking a Revenue Cycle Analyst - Denials & Appeals to support post-appeal response tracking within Billing Operations. You will provide data-driven insights, analyze workflows, and report performance to identify backlog trends and SLA compliance. The role bridges...Remote job
$60.2k - $107.4k
Improve the lives of others while Caring. Connecting. Growing together. Job Description - Appeals Grievances & Dispute Analyst Team Lead - Kelsey-Seybold Clinic - Pearland (2381036) Appeals Grievances & Dispute Analyst Team Lead - Kelsey-Seybold Clinic - Pearland - 23...Minimum wageFull timeWork experience placementLocal area$93.14k - $124.8k
...lives. Reporting to the Manager, Patient Financial Services, the Clinical Analyst plays an important role on a high‑profile team tasked with handling all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high‑level...Remote job$65.4k - $95.2k
Revenue Cycle Analyst - Denials & Appeals US Remote POSITION SUMMARY The Revenue Cycle Analyst - Denials & Appeals (Unresponded) supports the post-appeal response tracking function within Natera's Billing Operations by providing data-driven insights, workflow analysis,...Remote jobWork at officeImmediate startWorldwide$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- Beth Israel Lahey Health is seeking a Clinical Analyst to join the Patient Financial Services team and lead complex clinical appeals, audits, and compliance initiatives across inpatient and outpatient settings. You will ensure medical necessity and appropriate level of...Remote job
$34 - $38 per hour
Cotiviti is seeking a Coding Validation Analyst I to perform daily audits on client data for completeness and accuracy of coding... ...to ensure proper reimbursement and respond to provider appeals. This is a remote, shift-based role across MT and ET time zones with after-training...Remote jobHourly payShift 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
$22.99 per hour
...analytical problem solver with a passion for healthcare managed care? We are seeking dedicated Grievance & Appeals Coordinators to join our growing, collaborative team! In this fully remote role, you will analyze and resolve complex member and provider appeals and grievances,...Remote workHourly payPermanent employmentTemporary workWork experience placementWork at officeWork from homeHome officeShift workWeekend work- ...community every day. Shift: Monday- Friday 8:00-4:30 Location: Lingle Building, Remote Mississippi Job Description Summary Job Description Position Overview: The Denials and Appeals Analyst assists in the recovery of Health System revenue by managing the life cycle of denied...Remote workWork at officeMonday to FridayShift workWeekend workDay shift
- Metropolitan Transportation Authority (MTA) New York City Transit is seeking a Staff Analyst I/II or Associate Staff Analyst to administer ADA Access-A-Ride eligibility appeals. The role involves processing appeals, scheduling hearings, communicating with appellants, and...Remote job
- ...Medica is seeking an Appeals and Grievance Specialist to manage member complaints, grievances, and regulatory inquiries, ensuring timely, accurate... ...Operations, Health Services, Legal, and Markets. This is a remote position with a competitive total rewards package. #J-1880...Remote work
$70k - $80k
...Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider appeals. Candidates must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience...Remote workFull timeContract workMonday to Friday- ...To support a growing remote team, the full-time Appeals and Grievance Specialist will manage and resolve complaints, grievances, and appeals from members and providers while ensuring compliance with applicable requirements. Key responsibilities Manage and resolve complaints...Remote workFull time
- A staffing solutions company is seeking a Grievance & Appeals Coordinator for a fully remote position in Detroit, MI. This role involves processing appeals, grievances, and inquiries while maintaining accurate documentation and effective communication. The ideal candidate...Remote jobContract work
- The Fountain Group is hiring Grievance & Appeals Nurses for a prominent healthcare client. This is a fully remote, 6-month contract opportunity with a pay rate of $35.39-$45.39/hour. 40 hours per week; must be able to support Arizona business hours. Openings: 2. Location...Remote jobContract work
$30 - $35 per hour
...Mid-Senior Level professional for a contract role to manage grievances and appeals. Candidates should have 6+ years in customer service with strong... ...pay range of $30.00/hr - $35.00/hr based on qualifications. Remote work is available for candidates within 100 miles of...Remote jobContract workFor contractors- ...seeking a clinical professional to join our Medical Management/Health Services team to ensure proper processing of member grievances, provider appeals, and state fair hearings. You will serve as the primary contact with the State and oversee the daily activities of the...Remote job
$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 workHourly payFull time- Firstsource Healthcare is seeking a detail-oriented Claims & Appeals & Grievances (A&G) Specialist to join our Healthcare Operations team. The candidate should have at least two years of experience in US healthcare back-office operations with expertise in claims processing...Remote job
- ElderServe Health Inc in Bronx and remote options seeks a Paralegal II for Quality Appeals & Grievances to support research, reporting, and regulatory readiness. You will draft responses, audit appeals, and analyze outcomes under supervision. The role emphasizes data analysis...Remote work
- Sentara Health is seeking a Director of Appeals and Grievance to plan, develop, and direct department services for existing and new business opportunities... ...regulations, and manage audits (NCQA, EQRO, CMS, DMAS, BOI). Remote.US remote work supported. #J-18808-Ljbffr Sentara HealthRemote job
- ...Job Title: Grievance & Appeals Coordinator I Location: Remote in Indiana (**MUST be a resident of Indiana) Pay: $22 hourly - *weekly pay Position Purpose: Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal...Remote workHourly payWeekly pay
- Optum is seeking a Coding Quality Analyst to review patient records, craft defensible appeal letters, and ensure accurate application of ICD-9/ICD-10, DRG, CM/PCS, CPT, and HCPCS coding. The role involves data extraction, literature-backed arguments, and education of clients...Remote job
- ...Job Title Job Description Process appeals and grievances, analyze, research, and provide comprehensive responses in accordance with established... ...applying contract and regulatory provisions. This is a Remote Role Experience Experience handling a large load of...Remote workContract workApprenticeshipLocal area
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