Appeals & Grievances Specialist
CVS
CVS Health in the United States is seeking an Appeals, Complaints and Grievances Specialist to manage intake, investigation and resolution for all products, coordinating with multiple business units to ensure timely, customer-focused responses. You will research benefit language, plan design details and claim processing logic, identify trends and provide recommendations, while maintaining strong communication with members and providers. #J-18808-Ljbffr CVS Health
Vacancy posted 2 days ago
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Healthfirst
New York, NY3 days ago $22 - $23 per hour
Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity with long-term potential and is US ( Remote ). Please review the job description below and contact me ASAP if you are interested. Job Diva ID: 26-07046 Pay Range: $22.00 -...SuggestedContract workWork at officeLocal areaImmediate startRemote work$17 - $28.46 per hour
...to simplify health care one person, one family and one community at a time. Position Summary Review, research, and enter grievance and appeal cases within one business day of receipt. Monitor multiple intake sources, including call tracking, fax, email, and mail, and...Hourly payFull timeLocal area$58.9k - $80.07k
The Grievance Specialist is a member of the Appeals & Grievances (A&G) team at Healthfirst and is responsible for managing and resolving member or authorized representative-initiated grievances and complaints across Healthfirst’s product lines, including Medicare, Medicaid...Remote jobContract workTemporary workWork experience placementWork at office- HealthFirst is seeking a Grievance Specialist for the 100% remote Appeals & Grievances team. You will manage member grievances end-to-end, investigate with cross-functional partners, and ensure timely, compliant resolutions within regulatory standards. The role emphasizes...Remote job
$20.39 - $34.71 per hour
...Supports the documentation and processing of appeals, disputes and reconsiderations to ensure... ...Key Details: This fully remote Appeals Specialist position is open to candidates anywhere... ...candidate has experience with appeals, grievances, claims, or other regulated casework and...Hourly payFull timePart timeWork at officeRemote workFlexible hours$30 per hour
Hybrid-Appeals Specialist needed for a contract opportunity with Yoh's client located in Philadelphia, PA. Schedule: Tuesday-Wednesday-Thursday... .... Medicare experience Utilization Management or Appeals/Grievances experience preferred. Working knowledge of plan products,...Contract work- .... You will coordinate follow-up with third-party payors to secure reimbursement for institutional and professional claims, monitor appeals, and analyze performance data to drive improvements. Work closely with revenue integrity teams to streamline denial processes, ensure...Full timeRemote work
jobgether
New York, NY2 days ago - ...II to review and resolve complex claim denials by coordinating with payers, hospital departments and patients. The role emphasizes appeals research, rebilling, and balance transfers to the next responsible party. Ideal candidates have 3+ years in hospital revenue cycle,...Remote jobWork at office
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About the Role The incumbent manages end‑to‑end complaint and appeal cases, conducting thorough investigations, ensuring regulatory and... ...inquiries. Experience in health insurance, claim appeals and grievances preferred. Experience in complex claims processing necessary....Contract workLive inWork at officeLocal area- This role serves as the final point of contact for complex member issues, including health plan grievances, RD grievances, and advanced member account support and food benefits escalations This individual is responsible for resolving highly sensitive situations that require...Flexible hours
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Vanguard Group Staffing, Inc.
New York, NY2 days ago
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