Remote Medicare Appeals & Grievance Case Manager
$20 - $30 per hourPyramid Consulting, Inc
- Remote job
Pyramid Consulting, Inc in California is seeking a Member Appeals & Grievance Case Manager for a 6+ month contract with long-term potential. This remote position requires expertise in managing complaints and grievances in compliance with health plan standards. Ideal candidates will have over 3 years of experience in Appeals or Care Coordination, with a strong understanding of CMS regulations. The position offers a pay range of $20 - $30 per hour. #J-18808-Ljbffr Pyramid Consulting, Inc
$20 - $30 per hour
...Case Manager Appeals & Grievances (California) Immediate need for a talented Case Manager Appeals & Grievances (California). This is a 06+ months... ...opportunity with long-term potential and is located in California (Remote). Pay Range: $20 - $30/hour. Employee benefits include...Remote workContract workLocal areaImmediate start$30 - $35 per hour
...seeking a Mid-Senior Level professional for a contract role to manage grievances and appeals. Candidates should have 6+ years in customer service with... ...range of $30.00/hr - $35.00/hr based on qualifications. Remote work is available for candidates within 100 miles of...Remote jobContract workFor contractors- Sagility is seeking an Appeals and Grievance Coordinator who will manage and resolve member and provider complaints while adhering to regulatory requirements. This role involves conducting investigations, documenting actions, and ensuring compliance. As a key contact for...Remote jobWork from home
- CVS Health Corporation is looking for an Appeal and Grievance Coordinator who will work from home in Kentucky. This full-time role involves handling appeals, complaints, and grievances, ensuring timely responses while collaborating across multiple business units. The ideal...Remote jobFull timeWork from home
$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... ...Qualifications At least 2 years of managed care experience in a call center, appeals...Remote workHourly payFull timeContract workWork experience placementWork at office- ...Shift First (Days) Overview: Sentara Health Plansis hiring an Integrated Nurse Case Manager/Registered Nurse (RN) for Inpatient and Outpatient Clinical Appeals- Remote in Virginia! Status: Full-time,permanent position (40 hours) Standard working hours: 8...Remote workPermanent employmentFull timeTemporary workShift work
$248.5k - $373k
...Appeals And Grievances Medical Director At UnitedHealthcare, we're simplifying... ...the flexibility to work remotely from anywhere within the U.S... ...Responsibilities: Perform individual case review for appeals and... ...of Insurance/Department of Managed Healthcare, and CMS...Remote workMinimum wageWork experience placementLocal areaWork from home- ...dedicated professional to support the administration of the Appeals and Grievance process. The role involves acting as a liaison between... ...claims, services, and other concerns. Responsibilities include managing member appeals, ensuring compliance with regulatory time frames...Remote work
- ...Elevance Health is seeking a Grievance/Appeals Representative I to work virtually full-time, handling grievances and appeals related to service and benefit coverage issues. The representative will conduct investigations, communicate with customers, and generate written...Remote workFull time
- ...Elevance Health is seeking a Grievance/Appeals Analyst I to review and process non-complex grievances and appeals in the Enterprise Grievance & Appeals Department. This entry-level position allows for virtual work but requires in-person training sessions. The ideal candidate...Remote work
- ...Elevance Health in Tampa, Florida seeks a Grievance/Appeals Representative I to manage customer claims and ensure resolution of grievances. This role primarily involves analyzing and processing claims, with a significant focus on communication and documentation. The ideal...Remote workFlexible hours
- ...Cross Blue Shield of Arizona is seeking a skilled professional for a clinical role addressing provider appeals and grievances. This position demands expertise in managed care while ensuring compliance with privacy regulations. The ideal candidate will possess a relevant...Remote job
- ...L.A. Care Health Plan is seeking an Appeals and Grievances Specialist II in Los Angeles, CA. The role involves investigating member and provider... ...reports. Requirements include at least 2 years in Managed Care, knowledge of medical terminology, and excellent communication...Remote workFull time
- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote job
- A staffing solutions company is seeking a Grievance & Appeals Coordinator for a fully remote position in Detroit, MI. This role involves processing appeals, grievances, and inquiries while maintaining accurate documentation and effective communication. The ideal candidate...Remote jobContract work
- Texas Health Institute is seeking an Appeals and Grievances Medical Director who will be responsible for the clinical review and adjudication of appeals cases. This role offers the flexibility to work remotely from anywhere within the U.S. It involves communicating with...Remote job
- Mass General Brigham Health Plan Holding Company, Inc. is seeking a Duals Supervisor for Appeals and Grievances to lead a team responsible for overseeing the appeals process. The ideal candidate will have significant experience in healthcare appeals and grievances, regulatory...Remote job
$60.78k
Appeals and Grievances Specialist II Job Category: Customer Service... ...with Centers for Medicare and Medicaid Services... ...DHCS), Department of Managed Health Care (DMHC), Managed... ..., prepares case files and routes complaints... ..., holidays, a hybrid remote schedule, occasional...Remote workFull timeLocal areaShift workWeekend work- Geisinger is looking for a professional to provide support in the administration of the Appeals and Grievance process. This role involves liaising between members and the plan to address denied claims and benefit issues. Applicants should have a minimum of 5 years of relevant...Remote job
$248.5k - $373k
Texas Health Institute is seeking an Appeals and Grievances Medical Director to oversee the... ...adjudication of appeals and grievances cases. The candidate will manage communication between medical... ...experience. This role allows flexible remote work from anywhere in the United...Remote jobFlexible hours$23 per hour
A-Line Staffing Solutions is seeking a full-time Grievance & Appeals Coordinator I in the Natomas or Woodland Hills, CA area. In this role, you will coordinate the grievance and appeals process for members, ensuring timely responses in compliance with regulations. The ideal...Remote jobFull time$248.5k - $373k
Join UnitedHealthcare as an Appeals and Grievances Medical Director, working remotely from anywhere in the U.S. You'll oversee appeals and grievances for various health plan products while collaborating with medical directors. The role requires an MD or DO with board certification...Remote job$238k - $357.5k
UnitedHealthcare is seeking an Appeals and Grievances Medical Director responsible for clinical review of appeals for various health plans. This role offers flexibility to work remotely from anywhere within the U.S. The qualified candidate will have an MD or DO with an...Remote job- UnitedHealthcare is seeking an Appeals and Grievances Medical Director to review and adjudicate appeal cases. You will conduct reviews... ...clinical policies while working remotely within the U.S. The ideal... ...practice and quality management. This role offers a competitive...Remote job
- ...Job Description. Process appeals and grievances, analyze, research, and provide... ...communicate disposition of case. Conduct pertinent research... ...regulatory provisions. This is a Remote Role Experience; Experience... ...environment. Insurance, Medicare/Client knowledge Writing Letters...Remote workContract workApprenticeshipLocal area
- ...Somerville is seeking a Duals Supervisor for Appeals and Grievances to oversee a team and ensure... ...supervisory skills, and the ability to manage regulatory requirements effectively. Responsibilities... ...collaboration. This role allows for remote work with occasional onsite meetings....Remote job
- Pride Health is seeking a Grievances and Appeals Nurse for a remote contract position. This role is vital in investigating and resolving grievances and appeals efficiently for a well-known client. Responsibilities include acting as a subject matter expert, ensuring compliance...Remote jobContract work
$248.5k - $373k
UnitedHealthcare is seeking an Appeals and Grievances Medical Director to support the clinical review and adjudication of cases while offering flexible, remote work within the United States. The... ...and 2 years in quality management. Strong project management and communication...Remote jobFlexible hours- ...a G&A Coordinator to support a high-volume Grievances & Appeals team in the United States (Arizona residents only). This fully remote role focuses on member and provider appeals... ...experience. The position involves resolving complex cases while adhering to regulatory requirements....Remote job
$21 - $25 per hour
...Appeal And Grievance Coordinator One of Airetel Staffing's valued clients is... ...the internal appeal process remote M-F (8-hr shift that will start... .... Timely assignment of cases is critical to ensure member... ...standards, including the Center for Medicare and Medicaid Services (CMS)...Remote workShift work
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