Grievance Resolution Specialist (Remote)

Health First

Healthfirst is seeking a Grievance Specialist to join the Appeals & Grievances team. This remote role handles member grievances across Medicare, Medicaid, CHPlus, SHP, QHP, EP, and CompleteCare with a focus on timely, accurate resolutions. You will research issues across departments, coordinate with external vendors, and draft compliant letters. Strong MS Office and case-tracking skills are essential. #J-18808-Ljbffr

Apply

Vacancy posted 3 days ago

Similar jobs that could be interesting for youBased on the Grievance Resolution Specialist (Remote) in Austin, TX vacancy

Grievance Resolution Specialist (Remote)
...Healthfirst is seeking a Grievance Specialist to join the Appeals & Grievances team. This remote role handles member grievances across Medicare, Medicaid, CHPlus,... ...CompleteCare with a focus on timely, accurate resolutions. You will research issues across departments...
Remote work
Health First
United States
3 days ago
Grievance Resolution Specialist
$25 - $37 per hour
...Kinetic Personnel Group is currently recruiting for a Grievance Resolution Specialist for a Public Health Agency (government entity). This position will be based in Orange County. This 3 billion-dollar a year government public agency is renowned for its work in the community...
Remote work
Permanent employment
Full time
Contract work
Temporary work
Work at office
Kinetic Personnel Group, Inc
Orange, CA
3 days ago
Remote Member Advocacy and Case Resolution Specialist
...Member Advocacy Coordinator to manage ODAG cases from intake to resolution in a remote setting. You will investigate, document, and coordinate... ...compliance, with strong emphasis on timely, compliant handling of oral dissatisfaction, appeals and grievances. #J-18808-Ljbffr
Remote work
Mass General Brigham Health Plan, Inc.
United States
4 days ago
Medicare Appeals & Grievances CX Specialist - Remote KS
...Shield of Kansas seeks an experienced MA Appeals and Grievances Specialist to provide exceptional customer service while... ...representative inquiries and ensures timely, accurate resolutions. Location allows remote or onsite work within Kansas/Missouri with relocation...
Remote work
Relocation
Blue Cross & Blue Shield of Kansas, Inc.
United States
2 days ago
Remote Grievance & Appeals Specialist
...Healthfirst seeks a Grievance Specialist to join the Appeals & Grievances team. This is a 100% remote, non-clinical role focused on resolving member grievances across Medicare... ...vendors, and ensure timely, accurate resolutions in compliance with regulatory standards. #J...
Remote work
Health First
United States
1 day ago
Grievance Specialist
...Managing and resolving member-initiated grievances, the full-time remote Grievance Specialist will advocate for Healthfirst members by conducting thorough investigations and ensuring compliant resolutions across various product lines, including Medicare and Medicaid....
Remote work
Full time
Work at office
Virtual Vocations Inc
United States
2 days ago
Psychiatric Complaints and Grievances Specialist (Remote)
...field of mental healthcare. Rula is a remote-first company. We currently hire in most... ...are hiring a Psychiatric Complaints & Grievances Specialist to join our Psych Clinical Quality... ...role, you'll own the clinical review and resolution of psychiatric complaints and...
Remote work
Full time
Live in
Currently hiring
Home office
Rula
Remote
1 day ago
Specialist, Appeals & Grievances Medicare- Remote (EST or CST)
...and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with... ...Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related...
Remote work
Contract work
Work at office
Molina Healthcare
United States
3 days ago
Grievance Specialist- Remote
$58.9k - $80.07k
...The Grievance Specialist is a member of the Appeals & Grievances (A&G) team at Healthfirst and is... ...exclusively on grievance and complaint resolution. The Specialist plays a key role in... ...and Hours ~ This position is 100% remote - Schedule M-F, 8am-4:30pm or 8:30am-5...
Remote work
Contract work
Temporary work
Work experience placement
Work at office
Health First
United States
4 days ago
Grievance Resolution Specialist
...CoreCivic in Oklahoma seeks a Grievance Coordinator to manage the inmate/resident grievance process in a secure setting. The role involves investigating grievances, coordinating informal resolutions, and ensuring timely, compliant responses with proper documentation....
Work at office
CoreCivic
Cushing, OK
2 days ago
Remote Appeals & Grievances Specialist (RN/LPN/DH)
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
Healthfirst
United States
1 day ago
Lead Specialist, Appeals & Grievances (Remote)
...and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with... ...lead for submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members, providers and related...
Remote work
Contract work
Work at office
Molina Healthcare
Phoenix, AZ
3 days ago
Appeals & Grievance Resolution Specialist
...CVS Health is seeking an Appeals Specialist in Oklahoma City to manage intake, investigation and resolution of appeals, complaints and grievances across products. You will coordinate responses from multiple units to deliver timely, member-focused outcomes and identify...
CVS Health
Oklahoma City, OK
2 days ago
Appeals and Grievances Specialist II
$60.78k
...Job Summary The Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve... ...judgment. This position will provide resolution of complaints in compliance with Centers... ..., on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours...
Remote work
Full time
Local area
Shift work
Weekend work
L.A. Care Health Plan
Los Angeles, CA
19 hours ago
Appeals & Grievances Resolution Specialist
...CVS Health is seeking an Appeals, Complaints and Grievances Analyst to manage intake, investigations, and resolutions across products, coordinating responses with multiple units to ensure timely, customer-focused outcomes. The role requires 1–2 years of experience with...
Full time
CVS Health
Oklahoma City, OK
3 days ago
Patient Experience & Grievance Resolution Specialist
...OU Health is seeking a Patient Grievance & Relations Specialist II to support system-wide patient experience initiatives. The role emphasizes clinical context, service recovery, and timely complaint resolution across locations. Strong collaboration with multidisciplinary...
OU Medicine
Vancouver, WA
2 days ago
Lead Specialist, Appeals & Grievances
.... Our partner is looking for a Lead Specialist, Appeals & Grievances based in the United States. As a... ...receive accurate, timely, and compliant resolutions. You will serve as a key resource... ...retirement plans, paid time off, and remote or flexible work arrangements are...
Remote work
Full time
Contract work
Work at office
Flexible hours
Jobgether
Remote
6 days ago
Remote Case Resolution Specialist - Healthcare (PA)
...FreedomCare LLC is hiring a Case Resolution Specialist I to support patients and caregivers in Pennsylvania. This remote role involves one-call resolutions, enrollment guidance, and cross-functional collaboration to restore homecare services. You will manage communications...
Remote work
FREEDOM CARE , LLC
United States
2 days ago
Remote Case Resolution Specialist I - Patient Onboarding
...FreedomCare LLC in Pennsylvania is hiring a Case Resolution Specialist I for a remote role with occasional travel to the FreedomCare hub nearby. You will partner with patients and health plans to identify barriers to continuing services and help former patients restore...
Remote work
FREEDOM CARE , LLC
Lititz, PA
3 days ago
Remote Case Resolution Specialist
...FreedomCare LLC is seeking a Case Resolution Specialist I to support patients and caregivers remotely, with occasional travel to the nearest hub in Pennsylvania. You will serve as the primary contact for restoring services, guide enrollment, and coordinate with health...
Remote work
FREEDOM CARE , LLC
United States
5 days ago
Remote Case Resolution Specialist I
...FreedomCare LLC in Pennsylvania is seeking a Case Resolution Specialist I to support patients and health plans through onboarding, enrollment... ...restoration across our Pennsylvania homecare program. This remote role includes occasional travel to the nearest FreedomCare hub...
Remote work
FREEDOM CARE , LLC
United States
2 days ago
Card Dispute Resolution Specialist - (Hybrid Role) - LOCALS ONLY
...zilliontechnologies(dot)com // (***) ***-**** Debit Card Dispute Resolution Specialist $25-$27/HR W2 Duration: 6 Months Contract Direct... ...Hybrid Role - 3 Days a week onsite in Pensacola, FL / 2 Days Remote "Work sponsorship is not available for this position....
Remote work
Contract work
Local area
3 days per week
Zillion Technologies, Inc.
Pensacola, FL
1 day ago
Debit Card Dispute Resolution Specialist --- Locals Only ---Hybrid role
...shaily(at)zilliontechnologies(dot)com Debit Card Dispute Resolution Specialist Duration: 6 Months Contract Direct Banking Client Hybrid Role - 3 Days a week onsite in Pensacola, FL / 2 Days Remote "Work sponsorship is not available for this position....
Remote work
Full time
Contract work
Local area
3 days per week
Zillion Technologies, Inc.
Pensacola, FL
2 days ago
Enrollment Resolution Specialist I
...Univera Healthcare is seeking an Enrollment Resolution Examiner to resolve complex enrollment and billing issues across multiple enrollment... .... A background in health insurance enrollment and finance is preferred, with potential for remote case-by-case #J-18808-Ljbffr
Remote work
Univera Healthcare
Buffalo, NY
5 days ago
Asset Resolution Specialist
$45k - $67k
...competitive benefits and perks This position can be based remotely in any of our approved hiring regions. Our hybrid... ...experience for our customers and keep them coming back. As an Asset Resolution Specialist (ARS) with Kiavi you will be the point of contact for...
Remote work
Full time
Temporary work
Work at office
Immediate start
Flexible hours
Kiavi
Remote
3 days ago
Grievance and Appeals Specialist
...To ensure compliance with regulatory standards, the full-time remote Grievance and Appeals Specialist will manage appeals within specified timeframes, maintain and revise policies and procedures, and support contractual obligations in a healthcare environment. Key responsibilities...
Remote work
Full time
Virtual Vocations Inc
United States
8 hours ago
Remote Resolution Specialist - Healthcare CSR
...J&B Medical Supply Co Inc is seeking a Service Coordinator-Resolution Specialist to support patients and internal teams, handling escalated issues... ...for escalated members. This full-time role offers remote work within the specified states, with an in-office requirement...
Remote work
Full time
Work at office
J&B Medical Supply Co Inc
New York, NY
4 days ago
Resolution Specialist
...support the collection of past due loans, the full-time hybrid Resolution Specialist will manage member accounts, negotiate repayment options,... ...compliance with regulatory guidelines while working both remotely and in the office. Key responsibilities Collect on all past...
Remote work
Full time
Work at office
Virtual Vocations Inc
United States
3 days ago
Remote AR Resolution Specialist - Behavioral Health
...access to services and recovery-oriented treatment. The Accounts Resolution Specialist role supports financial viability by ensuring proper billing... ...companies, and leading denial resolution efforts. Remote work is available for a wide range of states, including KY,...
Remote work
Immediate start
Connections Health Solutions
Brooklyn, NY
3 days ago
Remote Resolution Specialist: Patient Care & Insurance
...J&B Medical Supply Co Inc is seeking a Service Coordinator-Resolution Specialist to support escalated patient issues and drive timely resolutions... ..., handling inquiries, and suggesting process improvements. Remote work is available for specified states; local in-office work...
Remote work
Work at office
Local area
J&B Medical Supply Co Inc
Athens, GA
2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Grievance Resolution Specialist (Remote). Be the first to apply!