Remote Clinical Appeals & Coding Specialist
Our Clients
- Remote job
Our Clients is seeking a Clinical Appeals Specialist based in the United States. The role involves reviewing and preparing appeals for denied healthcare claims, utilizing ICD-10 coding guidelines, and analyzing medical documentation for accuracy and compliance. The ideal candidate should have experience in clinical appeals writing or medical coding, demonstrate excellent analytical skills, and thrive in a remote work environment. Knowledge of MCG and DRG methodologies is preferred. #J-18808-Ljbffr Our Clients
- ...Denials Specialist Insight Global is seeking a fully remote Denials Specialist to support a Healthcare AI client. This... ...will leverage their denials and appeals expertise to evaluate and improve... ...medical necessity, authorization, coding, technical, etc.) Identify discrepancies...Remote workContract workPart timeMonday to FridayFlexible hoursShift workWeekend work
- ...L.A. Care Health Plan is seeking an Appeals and Grievances Specialist II in Los Angeles, CA. The role involves investigating member and provider complaints, ensuring compliance with various health regulations, and preparing reports. Requirements include at least 2 years...Remote workFull time
- ...Elevance Health is looking for a dedicated individual to handle customer grievances and appeals within the health insurance sector, ensuring efficient service and communication. The role offers a virtual work environment with a standard shift from 9:00 am to 6:00 pm EST...Remote workShift 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
$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...Remote workHourly payFull timeContract workWork experience placementWork at office- A healthcare solutions company is seeking an Appeals Coordinator to support the Appeals Department with administrative tasks and manage... ...processing, and excellent analytical and communication skills. Remote work options are available along with competitive benefits...Remote work
- Maximus is seeking a Senior Appeals Administrator for their California Independent Medical Review team. This role is vital in ensuring timely resolutions for medical review cases while enhancing the appeals process. The ideal candidate will have an associate degree with...Remote jobWork from homeFlexible hours
- ...a Friend Back Remote Work from Home Share... ...the interface between clinical departments and charge... ...The Revenue Integrity Specialist plays an important... ...local payer audit and appeals and collaborates with... ...clinical documentation and coding, including strong...Remote workFull timeWork experience placementLocal areaWork from homeDay shift
$19.5 - $21 per hour
...Description We are seeking a detail-oriented and experienced Appeals Specialist for our client in Middleburg Heights, Ohio. In this role, you... ...-$21.00 ~ Monday-Friday 8am-5pm ~3 months in office then remote ~ Benefits offered Key Responsibilities Review...Remote workWork at officeImmediate startMonday to Friday$50k - $55k
...accuracy, accountability, and clinical excellence to healthcare. As... .... Under the direction of the Appeals Department leaders, the Appeals... ...the department. The Appeals Specialist level II performs research,... ...frequent interruptions Remote Work Requirements High speed...Remote work- ...Senior Appeals Specialist Job Category: Medical Billing Full-Time Remote Middleburg Heights, OH 44130, USA +1 more locations Description Key Responsibilities: Work as needed in all appeal worklists, potentially with a focus on contracted or sensitive...Remote workFull time
- ...Member Complaint Resolution Specialist 100% remote candidates must live in one of the preferred 15 states (AZ, FL, GA, ID, IA, KY, MI, MS, NE... ...Responsible for the comprehensive research and resolution of the appeals, dispute, grievances, and/or complaints from Molina members...Remote workContract workLive inMonday to Friday
- ...registration, eligibility verification, coding, billing, and charge... ...services for payer audit and appeals processes.... ...functions. Experience with clinical documentation and coding, including... ...weekends Location : Remote- only candidates working from...Remote workFull timeLocal areaDay shift
$48.6k - $83.16k
...Responsible for processing expedited appeals: those that are complex in nature, require... ...times of the Expedited Appeal unit, the Specialists are required to work weekends and holidays... ...for authorized representative or needed clinical information. Conduct thorough...Remote workHourly payContract workWeekend work- ...classified as hybrid, onsite or remote. While the majority of our... ...job Responsible for utilizing clinical acumen and managed care... ...requests for member and provider appeals, grievances, reconsiderations... ...ICD- 9, ICD-10, HCPCS, and DRG coding Preferred Professional...Remote workFull timeContract workWork experience placementWork at officeLocal area1 day per week
- JOHNSON SERVICE GROUP (JSG) is looking for a Grievance and Appeals Coordinator to work remotely from California. The position requires resolving member complaints, managing case files, and supporting the Member Services unit. Candidates should have an Associate’s degree...Remote job
$20.08 - $30.06 per hour
CERIS is hiring an Appeals Representative in Fort Worth, Texas. The role involves reviewing and addressing provider inquiries and appeals while ensuring compliance with relevant regulations. The successful candidate will have strong attention to detail, excellent communication...Remote jobHourly pay- Geisinger is seeking a dedicated professional to support the administration of the Appeals and Grievance process. The role involves acting as a liaison between members and the Plan regarding denied claims, services, and other concerns. Responsibilities include managing...Remote job
$21.16 - $38.37 per hour
A healthcare provider is seeking a Medicare Appeals & Grievances Specialist to handle member appeals and grievances. This remote position requires strong experience in managed care, particularly with Medicare regulations. Ideal candidates will have excellent attention...Remote jobHourly payWork at office- 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
- CorVel Corporation in Fort Worth, Texas, seeks an Appeals Representative responsible for managing provider inquiries related to healthcare appeals. You'll analyze and address appeals to ensure compliance with regulatory guidelines and facilitate the appeal process efficiently...Remote jobFull time
- CorVel Corporation in Fort Worth, TX is looking for an Appeals Representative to manage provider inquiries and appeals efficiently following regulatory guidelines and client policies. Responsibilities include reviewing documentation, ensuring compliance, and initiating...Remote jobFull time
- ...Summary We are currently hiring for an Appeals Specialist to join BlueCross BlueShield of South Carolina... ...overtime. This role is fully remote or can sit onsite at 26 Century Blvd, Suite... ...medical claims processing, appeals, or coding strongly preferred Medicare Part...Remote workFull timeContract workFor contractorsWork experience placementSecond jobCurrently hiringWork at officeLocal areaShift work
- Zotec Partners is looking for an AR Specialist to manage claims follow-up in a remote working environment. The position entails identifying billing issues, processing appeals, and resolving correspondence issues. Candidates should have AR follow-up experience, a high school...Remote jobWork at office
$19 - $21 per hour
...Appeals Specialist Respond to all assigned levels of denials by submitting appeal letters and required documentation to insurance companies... ...and work with the patient to get the denial overturned. Remote: Although this position is listed as remote, the training period...Remote workHourly pay- Blue 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
$60.78k
Appeals and Grievances Specialist II Job Category: Customer Service Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID:... ...requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in...Remote workFull timeLocal areaShift workWeekend work- Blue Cross Blue Shield of Arizona needs a clinical expert for managing member and provider appeals. This remote position requires strong accuracy, knowledge of compliance timelines, and a focus on customer service. Applicants should possess a healthcare-related degree and...Remote job
- 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
$70k - $85k
...Reimbursement Specialist, Appeals Belay Diagnostics is an innovative, clinical lab working to transform the diagnosis and treatment of brain and spinal cord tumors... ...Revenue Cycle Specialist (CRCS), Certified Coding Specialist (CCS), or CPC. Preferred Qualifications...Full timeWork at officeLocal area
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