Remote Grievance & Appeals Specialist
Banner Health
- Remote job
Banner Plans & Networks in Arizona seeks a Grievance and Appeals Coordinator to manage the intake, review, investigation, and resolution of member grievances, appeals, and provider disputes in a remote setting. Candidates must reside in Arizona; you will document findings, coordinate with internal teams, and prepare professional correspondence while meeting regulatory timelines and providing accurate, timely resolutions. #J-18808-Ljbffr Banner Health
$30.7k - $66.5k
...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 regulatory...Remote workFull timeContract workWork at office$38.17k - $66.5k
...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 workFull timeContract workWork at office$60.78k
...Appeals and Grievances Specialist IIJob Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...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
- Banner Plans & Networks is seeking a remote Grievance and Appeals Coordinator to manage intake, review, investigation and resolution of member grievances, appeals and provider disputes. The role demands accuracy, timely communication and cross-functional coordination to...Remote jobMonday to FridayShift work
- Banner Health is seeking a Health Plans Grievance and Appeals Coordinator in a remote role. You will manage grievances, appeals, and disputes for members and providers, ensuring timely investigations and communications. The role requires knowledge of AHCCCS, HCG, CMS rules...Remote job
$56.27k - $69.9k
Pay Plan Title: Appeals or Grievances Specialist II Working Title: Appeals Specialist II FLSA Status: Exempt Posting Salary Range: $56,270 - $69,898 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact Trillium Health Resources is...Remote workFull timeWork at officeLocal areaImmediate startWork from homeFlexible hours- AHCCCS in Phoenix seeks an Advocacy Program Specialist to deliver Special Assistance for... ...and help protect rights while navigating grievance and appeals processes. The role requires travel within the Phoenix area and possible remote work based in the Phoenix Metropolitan...Remote job
$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 jobHourly payWork at office- ...contract role with a New York health plan. You will own clinical grievances and appeals from intake to final decision letters, applying medical... ...judgments based on InterQual/MCG criteria. The position is 100% remote in the United States, with business hours and occasional...Remote workContract workAfternoon shift
- ...Randstad USA is seeking a Grievance and Appeals Intake Coordinator to join our operations team in a work‑from‑home setting. You will screen executive complaints, member grievances, and provider appeals in the PRIME platform, classify cases, and route them to specialized...Remote workWork from homeFlexible hoursWeekday work
$50k - $60k
...funded and fully funded programs, and delivered tangible savings and enhanced experiences for millions of members. The Appeals & Disputes Specialist is responsible for reviewing, investigating, and resolving member appeals and provider disputes for benefit plans,...Remote workFull timeWork at office$47.84k - $62.4k
...all applications and next steps. Our partner is looking for an Appeals Specialist based in the United States. As an Appeals Specialist, you... ...program. ~401(k) retirement savings plan. ~ Fully remote working arrangement within the United States. ~ Opportunity...Remote workHourly payFull time$41.6k - $54.08k
...ongoing business needs. Impact you will make The Denials Appeals Specialist is responsible for analyzing, drafting, and submitting high-quality... ...in a productivity and quality metrics-driven environment Remote work experience in a structured environment Experience...Remote workPermanent employmentContract workFor contractorsWork experience placement$19.43 - $32.98 per hour
Centene Management Company LLC in Tempe, AZ is seeking a claims, grievances and appeals specialist to analyze and resolve verbal and written appeals from providers and respond to member grievances. The role requires residency in Arizona, a high school diploma (associate...Hourly payWork at officeFlexible hours- SafeRide Health is seeking an experienced Complaints and Grievance Coordinator responsible for processing complaints and grievances, including member grievances, appeals, and provider disputes. The role ensures cases are resolved according to client-specific requirements...
- Centene is hiring an in-office Grievances and Appeals Specialist in Tempe, AZ to analyze and resolve verbal and written claims and authorization appeals from providers and members. The role requires full-time availability and residence in Arizona. You will gather and report...Full timeWork at office
- CVS Health in Columbus, OH is hiring for a full-time Intake Analyst responsible for reviewing, researching, and entering grievance and appeal cases within one business day. You will monitor multiple intake sources and prioritize requests to meet state and plan requirements...Full time
- CVS Health in Ohio seeks a specialist to handle intake, investigation and resolution of appeals, complaints and grievances across multiple products. You will coordinate responses from multiple business units and ensure timely, customer-focused communication to members and...
- CVS Health is seeking a detail-oriented professional to manage intake, investigation, and resolution of appeals, complaints, and grievances across products. You will coordinate responses from multiple units and ensure timely, customer-focused resolutions. The role requires...
- Centene in Tempe, AZ is hiring for a full-time position focused on analyzing and resolving verbal and written claims, appeals, and grievances from providers and members. The role requires in-office presence in Tempe, with mailroom activities and related duties. Responsibilities...Full timeWork at office
$56.2k - $101k
...Position Purpose: Supervise the day to day operations of the Appeals and Grievance (A&G) staff and functions within the department ensuring... ...and distribute case load. Key Details : This position is remote/work from home. The role will support the states of Delaware...Remote workFull timePart timeWork at officeWork from homeMonday to FridayFlexible hoursWeekend work- CVS Health is seeking a detail-oriented professional to manage intake, investigation and resolution of appeals, complaints, and grievances across products. You will coordinate responses from multiple teams, identify trends, and propose solutions while ensuring timely, customer...
- MJHS in New York, NY seeks an A&G Coordinator to investigate and respond to member and provider appeals and grievances under CMS and DOH rules. In a non-clinical role, you will help ensure timely decisions and accurate documentation. You will determine the appropriate...
- Centene Corp. in Tempe, AZ is seeking a full-time Grievance and Appeals Analyst to analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members. The role requires being in-office at our Tempe...Full timeWork at office
$246.1k - $344.2k
...and reviews of medical records for appeals decisions. The Corporate Medical Director... ...or oversee clinical reviews of grievance and appeal cases for assigned... ...Neurology, and General Surgery clinical specialists Work Style: Fully remote living in the contiguous USA....Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayWeekend work- ...Leveraging expertise in claims adjudication and risk management, the full-time remote Appeals Specialist will guide clients through the appeals process, ensuring compliance and fair decisions while collaborating with internal teams and mentoring staff. Key responsibilities...Remote workFull timeContract work
- ...Job Title Appeals Specialist II - J00909 Address TX Job Description Manage and process appeals related to healthcare or insurance claims efficiently... ...and outcomes in the system. _***Critical Information***_ Remote work available. Shift and hours to be confirmed; compliance...Remote workFull timeShift work
$29.7 - $31.8 per hour
## Acute Coding Appeals SpecialistApply: Remote - Nationwide: Full time: Posted Today: R052289**Thank you for considering a career at Ensemble!*... ...70 - $31.80 based on experienceThe Acute Coding Appeals Specialist integrates medical coding principles and objectivity in...Remote workFull timeTemporary workWork at officeLocal area- CERiS, a division of CorVel Corporation, is seeking an Appeals Representative to handle provider inquiries and appeals via email, fax, telephone, or written correspondence. This is a remote role with strong emphasis on accuracy and timely processing in a compliant environment...Remote jobWork from home
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