Member Grievances Resolution Specialist
$51k - $80.07kRemote Jobs
Healthfirst is seeking a Grievance Specialist to manage and resolve member grievances across its product lines, focusing on regulatory compliance. The role involves collaborating with multiple departments to investigate concerns and ensuring timely resolutions. The ideal candidate should have a high school diploma or GED, with preferred qualifications including a bachelor's degree and related experience. This position offers a competitive salary, with salaries ranging from $51,000 to $80,070 based on location and experience. #J-18808-Ljbffr
$13.41 - $29.06 per hour
...claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in... ...letters and prepares responses to member appeals and grievances. Elevates appropriate appeals to the next level...SuggestedHourly payWork experience placementWork at office$28.85 - $31.25 per hour
...Thank you for considering Progyny! The General Member Reimbursement (GMR) Specialist is responsible for managing and resolving member reimbursement... ...cases, ensuring accurate processing and timely resolution. ~ Review documentation, validate eligibility, resolve...SuggestedHourly paySummer workWork at officeRemote workFlexible hours3 days per week- ...Grievance and Appeals Specialist VillageCareMAX 112 Charles Street, New York, NY 10014 VillageCare is looking for a self-motivated individual... ...accurately and appropriately while advocating for members. The specialist will act independently and communicate with...SuggestedFull timeWork experience placementWork from home
- Position Summary Creates a memorable Member experience by cultivating, maintaining, and enhancing relationships with a book of business... ...about the Member’s current relationship with TDECU. Problem Resolution Owns Member issues through resolution. Troubleshoots and resolves...SuggestedLocal area
$48k - $55k
...stakeholders. Equally important, we provide our members with high-quality support to ensure they... ...: The Member and Provider Experience Specialist serves as the first point of contact for... ...issues as appropriate to ensure timely resolution. Maintain confidentiality and adhere to...SuggestedContract workWork at officeRemote workMonday to Friday$22 - $23 per hour
...Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity... ...Review, process, and resolve member appeals and grievance cases in accordance... ...gather required information and support case resolution Maintain clear and professional communication...Contract workWork at officeLocal areaImmediate startRemote work$77.2k - $96.5k
...Overview Supervises and monitors department staff members' handling of grievances and appeals for all product lines, and ensuring compliance... ...Will Do: Supervises the intake, investigation and resolution of appeals and grievances, member and provider, for the...Work experience placementFor subcontractorFlexible hoursWeekend work- ...the G&A process; ensure that members have appropriate access to... ...Expedited Appeal unit, the Specialists are required to work weekends... ...authorization effectuation and resolution of cases.Perform necessary... ...all aspects of the complaint, grievance and appeal process and be...Hourly payContract workRemote workWeekend work
- ...Our main location is in Brookfield, Wisconsin. Our firm is proud of our culture, transparent communication, and teamwork. As a new member, you should be looking for a challenge in a business that is quickly expanding. Responsibilities Handling outgoing and inbound calls...Work at officeRemote work
- ...Lumexa Imaging is seeking an AR Resolution Associate to join our Revenue Cycle Management Team. This fully remote role involves resolving claim issues with payers and ensuring timely reimbursement. Responsibilities include examining unpaid claims, communicating with payers...Remote work
$85k - $120k
...Analyst / Associate – Recovery, Resolution & Funding Planning Treasury Division Role Overview: We are looking for a highly motivated... ...strategy. The Associate will work closely with senior team members to deliver high-quality analysis, documentation, and...Work at officeLocal areaRemote workWorldwide- ...Appeals Coordinator level II team member will assist Appeals... ...the department. The Appeals Specialist level II performs research,... ...investigation, and analysis of appeals, grievances, and other types of... ...clients to administer timely resolution. Responsible for all aspects...
$44.79k - $67.19k
...them. Together. The Remote Member Experience & Engagement Lead... ...to applicable complaint or grievance procedure. Assists in defining... ...Collaborates with the Trainer and QA Specialist in identifying training... ...and manage appropriate resolution. Problem-Solving Skills: Effective...Remote work$66.3k - $75.33k
...Municipal Credit Union is looking for a dedicated support representative in New York, NY, to assist members through outbound calls aimed at retaining accounts and enhancing overall member experience. The role requires a minimum of 3 years’ experience in a call center environment...Work at office- ...site is also home to key marketing programs including NYC Restaurant Week, NYC Broadway Week, and more. POSITION SUMMARY The Specialist, Member Programs & Services, supports member engagement, retention, and program participation by serving as a day‑to‑day resource for...Work at officeRemote workWork visaFlexible hours
$19 - $27 per hour
...Position Summary... What you'll do... Provides member service. Maintains the checkout area. Resolves member issues and concerns. Promotes Sam's Club products and services. Provides guidance and support to members regarding self-service technology. Processes member...Hourly payMinimum wageFull timeTemporary workPart time- ...A healthcare organization is seeking a Member Engagement Specialist to engage potential members and encourage them to enroll in a Kidney Health Management program. This fully remote position requires a high school diploma and 2 years of relevant experience in sales or...Remote work
- ...Position Title: Patient Relations Specialist Department: Patient... ...documentation, investigation, and resolution of patient and visitor... ...and visitor complaints and grievances with OU Health. Advocates for... ...safety for patients, workforce members, providers, and visitors through...Full time
- ...Anywhere Real Estate is looking for an experienced Advisory Title Officer to serve as a senior expert in the examination and resolution of title issues for real estate transactions. The role requires a deep understanding of residential and commercial title processes,...
$58.9k - $80.07k
...Marketplace Facilitated Enroller The MarketPlace Facilitated Enroller is responsible for identifying and educating potential members on all aspects of the plan including new Medicaid, CHP/EP/QHP and answering questions regarding plan's features and benefits. Responsible...Temporary workWork experience placementWork at officeRemote workAfternoon shift$65k - $85k
...Location/Remote United States Remote Team Member Full-Time Requisition #: COMPL002480... ...is processes quality-of-care complaints, grievances, and incidents. Duties include all aspects... ...findings with the medical director, and resolution processes. This position requires...Full timeWork at officeLocal areaRemote workWork from homeFlexible hours$66.3k - $75k
...team as a Patient Relations Specialist - Brooklyn - Required Spanish... ...our patients and family members, advocates for patients and... ...responding to patient complaints and grievances that may involve hospital or... ...,investigation, resolution, and response to the patient...Work experience placement$66.3k - $75.33k
...Municipal Credit Union in New York is searching for a motivated professional to join their team, focused on member retention and account support. The role requires making outbound calls and assisting inbound inquiries in a high-volume environment. Candidates should have...Full time$78k - $88k
...application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Member Engagement Specialist Full Time REG Remote - DC Area, US 3 days ago Requisition ID: 1116 Salary Range: $78,000.00 To $88,000.00 Annually Our...Full timeWork experience placementSeasonal workRemote work- ...ATCA is recruiting a healthcare executive advisory board member: a distinguished Alzheimer’s specialist with a track record in cognitive disorders, dementia care, neurodegenerative disease management, clinical innovation, or scalable specialty program development. This...
$25 - $35 per hour
...About the Role OurRitual is launching a new Concierge Model designed to give every member a guided, personalized start to their journey. As a Member Matching Specialist, you will be the first human touchpoint for new members, setting the tone for their experience...Hourly payPart timeFlexible hoursAfternoon shift- Healthfirst is seeking a Performance Support Specialist in New York City who will be responsible for resolving escalated customer complaint... ..., and maintaining a tracking system while reaching out to members. Qualified candidates should possess a high school diploma or...Work at office
$58.9k - $80.07k
Healthfirst is seeking a MarketPlace Facilitated Enroller in New York City to help identify and educate potential members about healthcare plans. This role involves conducting enrollment activities both remotely and in-person, and ensuring members recertify their healthcare...Work at officeRemote work- NYC Tourism + Conventions is seeking a Specialist, Member Programs & Services, to enhance member engagement and support program participation. You will maintain member data, coordinate outreach, and assist with membership initiatives. The role involves handling inquiries...
$17 per hour
Crunch Fitness in New York, NY, is seeking a Front Desk Representative to greet members and guests, check in clients, and facilitate member requests. The ideal candidate should be fluent in English, possess strong customer service skills, and have experience in a fast-paced...Hourly pay
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