Appeals Specialist
Virtual Vocations Inc
Researching and responding to inquiries from various stakeholders, the full-time Appeals Specialist will manage the appeals/dispute process remotely, ensuring timely and accurate customer service and resolution of issues. Key responsibilities Provides customer service and responds to inquiries via phone, fax, mail, or email Interprets requests and determines appropriate responses to resolve issues Conducts research using federal regulations and contract policies to support decisions Required qualifications High School Diploma or equivalent Three years of general office experience, with education or training substitutable on a year-for-year basis One year of experience in Medicare Qualified Independent Contractor appeals or Veterans Affairs, or professional business writing in healthcare, customer service, or legal industries Must have resided in the US for three of the last five years
- ...Workday is seeking a Grievance & Appeal Specialist to address appeals within required timeframes and ensure contractual obligations are met. The role centers on accurate claims handling and timely resolutions in a fast-paced healthcare environment. You will maintain...SuggestedRemote work
- ...Point32Health, Inc. is seeking an Appeals and Grievance Coordinator to manage day-to-day tasks within the A&G department. You will process mail, assign cases, and support analysts while ensuring compliance with regulatory timelines. The role requires 1-2 years of relevant...SuggestedRemote workWork from home
$46.37k - $60.86k
...Hi, we're Oscar. We're hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar...SuggestedRemote jobFull timeWork at office$16 - $18.45 per hour
...Position: Appeals Specialist Location: Remote, US Salary: $16.00-18.45 hourly Overview J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since company inception in 2017 as a healthcare management consulting...SuggestedHourly payFull timePart timeFor contractorsWork at officeRemote work- ...Member Appeals Specialist Primary responsibilities would include triaging incoming appeals/grievances, categorizing them appropriately, assigning them to the team, making outbound calls when necessary. Also checking voicemails, responding to emails/voicemails. The...SuggestedTraineeshipRemote work
$51k - $80.07k
The Appeals & Grievances (A&G) unit processes member and non-contracted provider appeals for all of HF’s line of businesses which include... ..., dual enrollments, Medicare and complete care. Appeals Specialist is the subject matter expert responsible for non-clinical case...Full timeTemporary workWork experience placementRemote work$60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13321 Salary Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00...Full timeLocal areaRemote workShift workWeekend work- ...Overview: Respond to all assigned levels of denials by submitting appeal letters and required documentation to insurance companies within the appeal filing time limits. Submit external review requests and required documentation to the state within the filing time limits...Remote work
- ...Kingdom. Position Summary This position is responsible for monitoring insurance denials by running relevant reports and documenting appeal results in MS4 and MIDAS, ensuring proper notification to providers and members. The individual oversees staff handling post-...Work experience placementLocal areaRelocation package
$31.25 - $33.65 per hour
...Appeals Specialist Remote GeneDx delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable...Work at officeRemote workWork from homeHome office$40.12k - $47.84k
...environment! DaVita is currently looking for a Patient Account Specialist. Individuals who excel in this role are highly ambitious,... ...have to wear a tie again! Open to remote candidates Denials/Appeals experience preferred Candidate will be expected to work PST...Hourly payMinimum wageFull timeWork at officeRemote work$23 per hour
TEKsystems is seeking a Contract Grievances and Appeals Specialist for a fully remote role based out of Columbus, OH. The position analyzes and resolves verbal and written claims and appeals from providers and members, and prepares response letters. This is a contract...Remote jobHourly payContract work- UT Southwestern Medical Center in Dallas, TX, seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers, maximizing collections. The role emphasizes follow-up and resolution of denied claims with...Remote job
- ...Endeavor Health in Arlington Heights, IL seeks a Denial Management Specialist to review and resolve denied patient insurance claims,... ...with Physician Practices, Providers and Payers, submit timely appeals, gather medical records, and write appeal letters. Strong computer...
- ...Southwoods Health in Oregon is seeking a Denials Management Specialist to actively pursue payments from insurers by following up on aged, unpaid claims and handling strategic appeals. The role emphasizes proactive communication with carriers and timely resolution to improve...
- ...member and provider complaints, and reconsideration and redetermination requests. Review and respond to complaints, grievances and appeals within the stated time frame for each request. Certify that providers and members are reimbursed accordingly using Medicare...
$22.74 - $27.79 per hour
...apex of innovation and application. It’s time for your next chapter. Discover your story with Adaptive. Position Overview The Appeals Specialist is responsible for managing insurance claim appeals to ensure proper reimbursement for molecular and genetic testing services...Hourly payWork at officeRemote workNight shift$1,000 per month
Denials and Appeals Specialist (Level 3) Department: Revenue Cycle Employment Type: Permanent - Full Time Location: HQ Reporting To: Revenue Cycle Manager Description Aspire Allergy & Sinus is seeking a full-time Medical Accounts Receivable Specialist (Level 3) to serve...Permanent employmentFull timeWork at office- ...mainly with insurance companies, and supporting efficient cash flow. Responsibilities include payer research, root-cause analysis, appeals, and active communication with payers and patients. The ideal candidate has 2+ years in medical billing/collections within a large...Work at office
- MAHEC in Asheville is seeking a Prior Authorization Specialist to manage authorizations for in-house procedures, Medicare HMO visits, radiology... ...approvals, address denials, support Peer-to-Peer requests and Appeals, and assist with other areas needing authorizations and...Work at office
- ...Management Coordinator to review denials, identify patterns, and collaborate with frontline staff to improve processes. You will articulate appeals to carriers and document outcomes in the hospital information system. The role requires strong analytical, negotiation, and...
- MedImpact Healthcare Systems, Inc. is seeking an Appeals and Grievances Coordinator I to manage intake, processing, notification, and compliance for appeals and grievances in a fast-paced environment. The role supports accuracy and timely processing under supervisor guidance...Weekend work
- Oms Medical Billing in Addison, TX is hiring an Appeals Specialist. This full-time position requires on-site presence during regular business hours at our corporate office. The ideal candidate will review denied claims, prepare and submit appeal letters, and communicate...Full timeWork at office
- ...to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Medical Appeals Specialist in the Tacoma, WA area seeking a great career opportunity? Have you recently been seeking out prestigious, national healthcare...Hourly payContract workPrivate practice
- Job Overview OrthoMed Anesthesia, located in Addison, TX, is seeking a detail-oriented Appeals Specialist. The role is full-time and requires on-site presence during regular business hours at our corporate office. Key Responsibilities Review denied claims and determine...Full 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...Hourly payFull timeContract workWork experience placementWork at officeRemote work$48.5k - $70.5k
...year history of providing health insurance that works for our members, no matter their circumstances. Job Summary The Appeals and Grievance Specialist is responsible for managing the resolution process of medical and pharmacy member appeals and/or member generated...Contract workWork at officeFlexible hours- ...denied claims by identifying reasons for denial or dispute and collaborating closely with Nurse Auditors to support medical necessity appeals. This position requires preparing and submitting accurate appeal documentation, conducting thorough research to gather supporting...Work at officeLocal area
- A healthcare service company is seeking a G&A Coordinator in Detroit, MI. This role involves processing appeals, grievances, and inquiries from members, requiring strong analytical and communication skills. The ideal candidate will have a bachelor's degree and experience...
- The New York City Department of Housing Preservation and Development seeks a Community Coordinator to join the Appeals Unit. The role focuses on handling hearings and reviews for Section 8 and related rental subsidy programs, coordinating with HAS, DTOR, and other units...
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