Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Grievance & Appeals Coordinator

$22 - $23 per hour

Pyramid 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

Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Grievance & Appeals Coordinator in Richmond, VA vacancy
  • $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... 
    Suggested
    Hourly pay
    Full time
    Temporary work
    Local area

    CVS Health

    Richmond, VA
    3 days ago
  • $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... 
    Suggested
    Full time

    Hispanic Alliance for Career Enhancement

    Richmond, VA
    3 days ago
  • $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... 
    Suggested
    Immediate start
    Remote work

    Evolent

    Richmond, VA
    2 days ago
  • $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... 
    Suggested
    For contractors
    Local area

    Highmark Health

    Richmond, VA
    6 days ago
  • $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... 
    Suggested
    Remote work

    Med Review Inc

    Richmond, VA
    5 days ago
  •  ...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 time
    Part time
    Remote work
    Flexible hours

    Izzy World Travels

    Richmond, VA
    5 days ago
  •  ...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 office
    Local area

    Pyramid Healthcare

    Richmond, VA
    3 days ago
  • $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

    Guidelight Health

    Richmond, VA
    8 hours ago
  •  ...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 office
    Local area

    Wellington Regional Medical Center

    Richmond, VA
    1 day ago
  • $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 pay
    Full time
    Temporary work
    Local area
    Immediate start
    Remote work
    Monday to Friday
    Flexible hours
    Shift work

    Cardinal Health

    Richmond, VA
    3 days ago
  • 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 time
    Work at office
    Immediate start
    Remote work

    PACS Group, Inc.

    Richmond, VA
    2 days ago
  •  ...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... 

    Shared Services Center - Nashville

    Richmond, VA
    3 days ago
  • $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 work
    Work at office
    Local area
    Remote work

    Ensemble Health Partners

    Richmond, VA
    2 days ago
  •  ...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 time
    Part time
    Work at office
    Flexible hours

    OrthoVirginia

    Richmond, VA
    5 days ago
  • 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

    Universal Hospital Services Inc.

    Richmond, VA
    1 day ago
  •  ...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 office
    Local area

    Universal Hospital Services Inc.

    Richmond, VA
    1 day ago
  •  ...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.... 

    Universal Hospital Services Inc.

    Richmond, VA
    1 day ago
  •  ...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 pay
    Weekly pay
    Minimum wage
    Full time
    Seasonal work
    Local area
    Immediate start
    Weekend work
    Afternoon shift

    PetSmart

    Richmond, VA
    1 hour ago
  •  ...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 placement
    Work at office
    Local area
    Flexible hours

    TemPositions Group Of Companies

    Richmond, VA
    1 day ago
  •  ...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 time
    Part time
    Local area

    Capital One

    Richmond, VA
    10 days ago
  •  ...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 start
    Flexible hours

    STASHED

    Richmond, VA
    2 days ago
  •  ...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 time
    Remote work
    Shift work

    Slash Staffing

    Richmond, VA
    3 days ago
  • 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... 

    Virginia Commonwealth University Health Systems

    Richmond, VA
    2 days ago
  • $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 work
    Local area
    Remote work
    Worldwide
    Flexible hours

    Cogstate

    Richmond, VA
    2 days ago
  •  ...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 contract
    Flexible hours

    Insight Global

    Richmond, VA
    2 days ago
  •  ...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

    Virginia Commonwealth University Health Systems

    Richmond, VA
    3 days ago
  • 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 time
    Afternoon shift

    Master Center for Addiction Medicine

    Glen Allen, VA
    4 days ago
  • 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 work
    Flexible hours

    Live the Dash Travel

    Richmond, VA
    2 days ago
  •  ...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 area
    Remote work
    Flexible hours

    Fabventure Travel

    Richmond, VA
    5 days ago
  • $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 pay
    Temporary work
    Relief
    Work at office

    Akahi Associates/Kako'o Services, LLC

    Richmond, VA
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Grievance & Appeals Coordinator. Be the first to apply!