Remote Nurse Appeals & Hearings Specialist
$80k - $99.2kGainwell Technologies
Gainwell Technologies is seeking a Nurse Reviewer Appeals and Hearings to perform appeal-related duties, including analyzing and responding to provider appeals and participating in virtual and on-site hearings. You will prepare case files and ensure all documentation is addressed accurately. The ideal candidate will have an active RN license, over 5 years of clinical or medical coding experience, and excellent communication skills. This remote position includes a salary range of $80,000 to $99,200 annually with additional benefits. #J-18808-Ljbffr
- ...Downtown Boulder Partnership is seeking a Nurse Reviewer for Appeals and Hearings to coordinate and perform all appeal-related duties, including analyzing... ...for hearings. This position is a full-time, permanent remote role that complies with work-from-home policies. The...Remote workPermanent employmentFull timeWork from homeFlexible hours
$90k - $99k
...seeking a talented individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform all appeal... ...Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical... ...What you should expect in this role Remote (Work from Home) Up to 25% Travel...Remote workFull timeWork from homeRelocation packageFlexible hours- ...Working remotely in a full-time capacity, the RN Appeals and Grievances Specialist will manage the appeals process, review grievances, and ensure compliance with regulatory requirements. Key responsibilities Manage and oversee the appeals process for clinical cases...Remote workFull time
- ...A company is looking for an Appeals Specialist II - RN (REMOTE). Key Responsibilities Reviews and resolves pre-payment insurance denials in collaboration... ...H.S. Diploma or GED required Bachelor's Degree in Nursing preferred 2-4 years of experience in healthcare revenue...Remote workWork at office
$90k - $99k
A leading healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage in hearings, both virtual... ...an active RN license and coding certification. This remote role offers flexibility and opportunities for career development...Remote workFlexible hours- ...reward your expertise and dedication. Job Summary The Appeal Specialist II reviews, analyzes, and resolves insurance denials to ensure... ...Qualifications ~ H.S. Diploma or GED required ~ Bachelor's Degree in Nursing preferred ~2-4 years of experience in healthcare revenue...Remote workWork at officeLocal area
- ...Appeals Specialist Job Category: Medical Billing Requisition Number: APPEA001712 Posted: May 6, 2026 Full-Time Remote Middleburg Heights, OH 44130, USA Description Responsibilities... ...mail them. Coordinate phone hearings with the insurance company,...Remote workFull time
$50k - $55k
.... Under the direction of the Appeals Department leaders, the Appeals... ...the department. The Appeals Specialist level II performs research,... ...External Reviews and/or State Fair Hearing Manage and monitor all... ...atmosphere of frequent interruptions Remote Work Requirements High speed...Remote work- L.A. Care Health Plan is hiring an Appeals and Grievances Nurse Specialist RN II in Los Angeles. This role involves assisting members with healthcare access issues and resolving complaints in compliance with regulatory standards. The ideal candidate must have an Associate...Remote job
$90k - $99k
A healthcare solutions company is seeking a DRG Nurse Reviewer Appeals and Hearings to handle appeals from providers and participate in hearings. This remote position requires an active RN license and certification in coding. The ideal candidate will possess excellent communication...Remote workFlexible hours- ...established by the Centers for Medicare and Medicaid Services (CMS). Essential Job Duties Enters denials and requests for appeals into information system and prepares documentation for further review. Researches claims issues utilizing systems and other...Remote workWork at officeWeekend work
- ...up actions as advised Research claim variances in hospital patient accounting systems (EPIC, Meditech, Cerner, Athena) Draft appeals to insurance carriers on denied or underpaid claims Review claim detail including coding, billing and insurance information for...Remote workPermanent employmentWork from homeFlexible hours
- ...care in America’s heartland. Facility: Remote SD (Central Time) Location: Remote, SD... ...Summary Facilitates the denial and appeal process through exercising clinical expertise... ...Graduate from a nationally accredited nursing program preferred, including, but not limited...Remote workFull timePart timeImmediate startWork from homeShift workDay shift
$60.2k - $107.4k
...medical records; and craft strongly defensible appeal letters per process instructions and the... ...in ALJ (Administrative Law Judge) hearings as representatives of the clients during... ...providing high quality reviews. The Appeals nurse will perform their job functions, adhering...Remote workMinimum wageFull timeWork experience placementLocal area- ...re your trusted partner in innovation. The Redetermination (Appeals) Specialist supports the Medicare Appeals team by performing non-medical... ...information. Strong spelling, grammar, and punctuation skills. Remote, work from home M-F, 40 hours a week 401(k) & matching...Remote workFor contractorsWork experience placementWork at officeWork from home
$50k - $55k
...MedReview is seeking an Appeals Coordinator in the United States to manage appeals and grievances while ensuring timely resolutions. Candidates should have at least 3 years of healthcare experience, with strong problem-solving and analytical skills. Responsibilities include...Remote work- ...To support a growing teleaudiology practice, the fully remote Pennsylvania Licensed Hearing Specialist will conduct remote evaluations, device fittings, and follow-up care for patients while collaborating with the Sales Team to enhance patient experiences. Key responsibilities...Remote work
- ...A company is looking for a Remote Hearing Instrument Specialist. Key Responsibilities Conduct remote evaluations, device fittings, and follow-up care for patients Educate and guide patients on maximizing their hearing technology Collaborate with the Sales Team to ensure...Remote work
- ...A healthcare company is seeking a skilled Appeals Processor III to work remotely in the United States. This role involves reviewing and processing healthcare appeals related to Medicaid or Medicare coverage decisions. The ideal candidate will have at least 2 years of...Remote work
- ...A healthcare management company is seeking an Appeals Representative who will handle provider inquiries and appeals in a remote capacity. The ideal candidate has extensive knowledge of the healthcare revenue cycle and excellent communication skills. Key responsibilities...Remote workFull time
- ...A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage... ...processing, and excellent analytical and communication skills. Remote work options are available along with competitive benefits...Remote work
- A leading healthcare consulting firm is seeking a Grievance & Appeals Coordinator I for a contract role. Responsibilities include managing member appeals, ensuring compliance with CMS guidelines, and maintaining a high productivity benchmark. Candidates need a high school...Remote workContract work
- ...retrospective, and concurrent review of appeals for denied prior... ...administrative law judge pre-hearings, state insurance commissions,... ...• At least 2 years clinical nursing experience, including at least... ...CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager...Remote workWork at office
$27.88 - $36.06 per hour
A healthcare service provider is seeking an AR Follow-Up Specialist III, focusing on resolving coding-related denials and appeals while collaborating with coding professionals. This remote role requires strong customer service skills and a minimum of two years of relevant...Remote workHourly pay$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- ...Managing the resolution process for medical and pharmacy member appeals and grievances, the full-time remote Appeals and Grievance Specialist will ensure compliance with regulatory requirements and accreditation standards while coordinating with internal departments and...Remote workFull timeWork at office
$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 UM, Appeals...Remote workHourly payFull timeContract workWork experience placementWork at office$18 - $24 per hour
...100% Virtual Responsibilities: Triaging incoming appeals and grievances, categorizing them appropriately, and assigning... ...required. Collaborating with team members such as Specialists, Supervisors, Quality Nurses, Medical Directors, and Pharmacy Team. Drafting...Remote work- ...Senior Appeals Specialist Job Category: Medical Billing Full-Time Remote Middleburg Heights, OH 44130, USA +1 more locations Description Key Responsibilities: Work as needed in all appeal worklists, potentially with a focus on contracted or sensitive...Remote workFull time
$22.99 per hour
...salary: $22.99 - $23 per hour shift: First work hours: 9 AM - 6 PM education: High School Responsibilities Knowledge of appeals, disputes and reconsiderations process preferred. Performs data entry to support the tracking, logging, and processing of...Remote workHourly payPermanent employmentTemporary workWork experience placementShift work
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