Grievance & Appeals Coordinator
$22 - $23 per hourPyramid Consulting
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 - $23.00/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities Review, process, and resolve member appeals and grievance cases in accordance with company policies and regulatory requirements Ensure accurate documentation and case tracking while meeting quality and compliance standards Communicate with internal teams to gather required information and support case resolution Maintain clear and professional communication throughout the case management process Identify opportunities to improve processes and contribute to continuous improvement initiatives Ensure cases are handled within required timelines while maintaining high accuracy Support team collaboration to improve operational efficiency and customer satisfaction Key Requirements and Technology Experience Key skills: 2-3 years of experience in appeals and grievance, Healthcare administration, Health insurance operations, and Customer service within a regulated environment Strong attention to detail and ability to maintain accuracy when reviewing case documentation Knowledge of healthcare regulations or compliance requirements Familiarity with Medicare or Medicaid guidelines Strong communication and collaboration skills Analytical thinking and problem-solving ability Comfortable using standard office tools such as Microsoft Word, Excel, Outlook, Teams, and OneDrive Experience handling complex or compliance-related cases Strong written communication and letter-writing skills Experience coordinating projects or working with cross-functional teams in a fast-paced environment High School Diploma or equivalent Our client is a leading Healthcare industry , and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. #J-18808-Ljbffr
$46.99k - $122.4k
...oriented? Are you comfortable corresponding with provider offices on patient medication inquiries? We are looking for a member appeal coordinator . The candidate must be a highly trained, certified pharmacy technician that has multiple years of experience within retail...SuggestedHourly payFull timeTemporary workLocal area$46.99k - $122.4k
The Hispanic Alliance for Career Enhancement in Richmond, VA is seeking a Member Appeal Coordinator to assist patients in accessing affordable medications. The ideal candidate will have 2+ years Certified Pharmacy Technician experience and a member-centric mentality. This...SuggestedFull time$18 - $20 per hour
...mission. Stay for the culture. What You'll Be Doing: The Coordinator, Intake Utilization Management at Evolent will serve as a... ...requests. Or relevant health care experience in claims or appeal & grievance. Required ~ Previous background/experience with Oncology...SuggestedImmediate startRemote work$19.39 per hour
...addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. ESSENTIAL... ...Participate as pharmacy representative in onsite member appeals and grievances sessions. Serve as a resource for technical staff. Other...SuggestedFor contractorsLocal area$50k - $55k
...and Readmission reviews. Under the direction of the Appeals Department leaders, the Appeals Coordinator level II team member will assist Appeals leadership... ...research, investigation, and analysis of appeals, grievances, and other types of complaints filed by providers and...SuggestedRemote work- ...We require a remote Travel Coordinator to provide premier customer service to clients. The travel industry continues to grow and to supply... ..., and desired budget Customize marketing materials to appeal to clients via social media platforms, bulletin boards, and flyers...Full timePart timeRemote workFlexible hours
- ...clinical staffing to obtain information for client reviews. Maintain daily UR database accurately. Perform Act 106 reviews and follow up appeals. Track all county referrals for documentation of admission calls. Maintain and participate in chart reviews to ensure proper...Work at officeLocal area
$20 - $30 per hour
...collaborating in advance with the primary treating clinicians. Coordinate Peer-to-Peer (P2P) Review preparation and assist with... ...Authorization Required (NAR) requests. Establish post denial appeal response recommendations. Obtain portal access to any utilization...Remote work- ...Appeals Specialist The Atlantic Region Central Billing Office ("ARCBO") or ("CBO") provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals...Work at officeLocal area
$21.4 - $30.6 per hour
...specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes Help patients understand their insurance...Hourly payFull timeTemporary workLocal areaImmediate startRemote workMonday to FridayFlexible hoursShift work- Staffing Coordinator-Full Time page is loaded## Staffing Coordinator-Full Timelocations: Remote - Pennsylvaniatime type: Full timeposted... ...in which work will be accomplished.• Review complaints and grievances pertinent to scheduling and staffing. Make necessary oral/written...Full timeWork at officeImmediate startRemote work
- ...A healthcare service provider in the United States seeks a Denials & Appeals Coordinator responsible for managing and resolving denials and appeals to ensure timely reimbursement. The ideal candidate should have a high school diploma or GED, along with 1-3 years of relevant...
$29.7 - $31.8 per hour
...Benefits Career Advancement This position pays between $29.70 - $31.80 based on experience Position Summary The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the performance of coding appeals activities. This role draws on...Temporary workWork at officeLocal areaRemote work- ...Orthovirginia Registration Coordinator At OrthoVirginia, you're part of a team dedicated to delivering expert orthopedic and therapy... ...eligibility, billing, insurance regulations, insurance benefits and appeal processes Must be able to understand and explain most...Full timePart timeWork at officeFlexible hours
- A major healthcare service provider is seeking an Appeals Specialist to resolve claims appeals and work with insurance firms. Candidates should have at least a high school diploma and preferred experience in appeals, which includes using Microsoft Office effectively. This...Work at office
- ...customer service to our affiliated Universal Health Services hospitals. The Atlantic Region CBO is seeking a dynamic and talented Appeals Specialist. The Appeals Specialist is responsible for the resolution of all appeals relating to technical issues identified during...Work at officeLocal area
- ...provider is seeking a DRG Nurse Auditor in Richmond, Virginia. This role involves analyzing clinical claim denials, drafting detailed appeal letters, and performing DRG validation reviews. Candidates should possess an RN or LPN license, ideally with a BSN degree....
- ...leader on duty. Address and administer associate complaints and grievances. Recognizes and celebrates associates driving overall... ...and attention to detail, particularly in maintaining a visually appealing store layout. Supervisory responsibility No direct...Hourly payWeekly payMinimum wageFull timeSeasonal workLocal areaImmediate startWeekend workAfternoon shift
- ...Description: Position Title: Recertification Coordinator Specialist Status: Direct Hire Location: Bronx, New York, Zip 10463– On-site Hours: Mon – Fri, 9 am–5 pm Pay: $60,000 - $70,000 Job Summary We are hiring an experienced Recertification Coordinator with at least 2...Work experience placementWork at officeLocal areaFlexible hours
- ...divh2Principal Coordinator - Time Labor Specialist/h2pCapital Ones Principal Coordinator - Time and Labor Specialist position will perform a wide variety of record keeping and processing activities to ensure associates time entries are updated in the system and inputs...Full timePart timeLocal area
- ...Sneaker Release Specialist and Coordinator Stashed is a startup offering an online community for sneaker and streetwear enthusiasts. Our membership provides priority access to the hottest drops, the most sought-after sneakers, and special events. Our platform gives members...Immediate startFlexible hours
- ...ABA Intake Specialist and Rethink Coordinator (South Africa) Preferred Candidate Region Philippines; South Africa Job Type Full time Job Opening Status In-progress Work Schedule Fixed Schedule Job Category Operations and Project Management Required Skills intakes rethink...Full timeRemote workShift work
- The Transplant Coordinator delivers and accurately documents direct, age-specific care to a patient or group of patients based on medical orders and an integrated, multidisciplinary plan of care. This job safely administers prescribed medications, identifying incompatibilities...
$55k - $65k
..., Cogstate’s assessments are used in more than 150 countries and over 2,000 clinical trials. About the Role We’re seeking a Coordinator, Learning Services to support the Learning Services team by efficiently organizing and executing learning content initiatives. Key...Temporary workLocal areaRemote workWorldwideFlexible hours- ...Insight Global is seeking an IT Service Coordinator to support one of our Virginia state clients, this will be onsite in the Richmond, VA area and a long term contract, with extensions. The ideal candidate thrives on building relationships, solving problems, and keeping...Long term contractFlexible hours
- ...The Sepsis Coordinator plays a vital role in the continued development, evaluation and implementation of sepsis treatment. The Sepsis Coordinator ensures adherence to the early goal-directed therapy bundle elements (as developed by the Surviving Sepsis Campaign) in collaboration...Work at office
- A leading addiction treatment facility in Virginia is seeking a dedicated IOP Coordinator for its evening program. The role involves providing Intensive Outpatient Services, including individual and group counseling. Qualified candidates will have a Bachelor's in a Behavioral...Full timeAfternoon shift
- A dynamic travel agency is seeking a Remote Travel Coordinator to assist clients in organizing their travel plans, ensuring each itinerary is budget-friendly and stress-free. Ideal candidates have strong organizational and communication skills, with a passion for travel...Remote workFlexible hours
- ...About the job Honeymoon Travel Coordinator - Remote Remote – work from anywhere. Must reside in the U.S. Responsibilities Collaborate with clients to understand their preferences, interests, and budget constraints to tailor unique honeymoon itineraries. Design...Local areaRemote workFlexible hours
$38.93 per hour
...Job Title: Nurse Coordinator (Level 1) Location: Richmond Federal Office Building Hourly Pay: $38.93/hr & Health & Wellness $4.93*/hr worked (in lieu of benefits) Benefits: Vested Vacation, sick leave, holiday leave, Life, Accidental Death and Dismemberment, Short...Hourly payTemporary workReliefWork at office
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