Remote Appeals & Eligibility Specialist
Minnesota Department of Human Services
Minnesota Department of Human Services is seeking an Appeals Specialist to support the Eligibility Appeals Unit in processing MHCP eligibility appeals. You will conduct intake, perform initial reviews, and coordinate information with multiple stakeholders to ensure accuracy and timeliness.
The role requires interpreting health care policies, applying statutes, and exercising independent judgment in a deadline-driven environment. Telework is eligible for Minnesota residents with approval.
#J-18808-Ljbffr$48.32k - $82.39k
...investigating and tracking member grievances and appeals, and provider claims disputes.... ...holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.... .... Benefits may be subject to program eligibility. Centene is an equal opportunity...Remote workHourly payFull timePart timeWork at officeFlexible hours$52k - $79.04k
...Appeals Specialist | Tyson & Mendes Are you a detail-oriented billing professional who enjoys solving... ...reimbursement program for non-attorney eligible team members (up to $3,500 per calendar... ...here . No recruiters/agencies #li-remote Pay Range $25—$38 USD...Remote workHourly payFull timeWork at office$41.6k - $54.08k
...Impact you will make The Denials Appeals Specialist is responsible for analyzing, drafting... ...resolution Investigate insurance benefits, eligibility, and claim information across multiple... ...quality metrics-driven environment Remote work experience in a structured...Remote workPermanent employmentContract workFor contractorsWork experience placement- ...Serves as team lead for submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members, providers... ..., including coordination of benefits, subrogation and eligibility criteria. • Experience with Medicaid and Medicare claims denials...Remote workFull timeContract workWork at office
$60.78k
...Appeals and Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances... ...complaint and appeals issues, including eligibility, access to care, claims, benefit,... ..., on weekends, holidays, a hybrid remote schedule, occasional flexibility in...Remote workFull timeLocal areaShift workWeekend work- ...Appeals, Disputes, and Reconsiderations Support Position Purpose: Supports the documentation... ..., and a flexible approach to work with remote, hybrid, field or office work schedules.... .... Benefits may be subject to program eligibility. Centene is an equal opportunity...Remote workFull timePart timeH1bWork at officeFlexible 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... ...of benefits (COB), subrogation and eligibility criteria. Experience with Medicaid and...Remote workHourly payFull timeContract workWork experience placementWork at office$22 per hour
...all every day. Program Administration Eligibility Specialist Location Austin, TX Hourly Rate $22hr... ...of Texas Hwy. with potential for remote work following the initial period. Your... ...completes, and submits applications, appeals, or other forms related to financial eligibility...Remote workHourly payWork at officeLocal areaMonday to Friday- ...Job Description Description: 100% REMOTE CANDIDATES MUST LIVE IN ONE OF THE PREFFERED... ...research and resolution of the appeals, dispute, grievances, and/or complaints... ...coordination of benefits, subrogation, and eligibility criteria. Familiarity with Medicaid and...Remote workContract workLive inMonday to Friday
$23 - $28 per hour
...full lifecycle of member/provider appeals from intake and eligibility validation through analysis, decision... ..., and collaborate with coding specialists, nurses, and physician reviewers to... ...26. Workplace Type This is a fully remote position. About TEKsystems We're partners...Remote workContract workTemporary work$25.09 per hour
...Assistance Services department. The eligibility list created by this vacancy... ...the department. Eligibility Specialists spend much of their workday... ...days can be performed in a remote-first environment. Regardless... ...and represent the county at appeal hearings. Maintain regular, punctual...Remote workHourly payFull timeContract workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work2 days per week$18 - $19 per hour
...Description Job Description IDR Response Specialist – Medical Claims & Appeals Location: Richardson, TX 75081... ...vision insurance, subject to plan eligibility and terms. ~401(k) retirement... ...full-time, office-based position. Remote and hybrid work arrangements are...Remote workFull timeWork at officeMonday to Friday$45.43k - $52k
...approach to challenges) Join our team and make a positive impact on the lives of others! We are looking for a Medicaid Eligibility Specialist for our Pennsylvania Team. Department & Position Overview: The Medicaid Eligibility Specialist focuses on...Remote workFull time- ...Job Description: Optim Orthopedics is seeking a full time Eligibility Specialist/Remote. Job Requirements: Reviews clinic schedules 48 hours in advance of appointment for designated locations and checks all eligibility and benefits to ensure patient insurance is...Remote workFull time
- ...seeking a Denials Management Follow Up Representative for a fully remote, full-time position in the United States. You will coordinate... ...for institutional and professional claims, monitor appeals, and analyze performance data to drive improvements. Work closely...Remote workFull time
- ...Supporting the documentation and processing of appeals, the full-time Appeals Specialist II will manage appeals, disputes, and reconsiderations to ensure... ...with state and NCQA requirements while working remotely. Key responsibilities Perform data entry to track, log...Remote workFull timeVisa sponsorshipWork visa
$46.1k - $55k
...Public Consulting Group, LLC. is currently seeking a Title IV-E Eligibility Specialist. This position will be part of the team responsible for PCG’... ...preferred. • 0-2 years of relevant work experience. #LI-Remote #LI-MB1 Compensation: Compensation for roles at...Remote workFull timeWork experience placementH1bWork at officeLocal area- CERiS, a division of CorVel Corporation, is seeking an Appeals Representative to handle provider inquiries and appeals via email, fax, telephone, or written correspondence. This is a remote role with strong emphasis on accuracy and timely processing in a compliant environment...Remote jobWork from home
- ...Leveraging expertise in claims adjudication and risk management, the full-time remote Appeals Specialist will guide clients through the appeals process, ensuring compliance and fair decisions while collaborating with internal teams and mentoring staff. Key responsibilities...Remote workFull timeContract work
$20 - $21 per hour
...Appeals Specialist Fully Remote • Allied Benefit Systems Overview Salary Range $20.00 - $21.00 Hourly Position Type Full Time Category Claims Description POSITION SUMMARY The Appeals Specialist will be responsible for the organization and completion...Remote workHourly payFull timeWork experience placementWork from home- ...Job Title Appeals Specialist II - J00909 Address Austin, TX Job Description Review and process appeals in accordance with policies and procedures... ...and organizational standards. _Critical Information_ Remote Shift/hours: standard hours (to be confirmed) Verify with a Recruiter...Remote workFull timeShift work
$18.25 - $24 per hour
A health care organization is looking for a Membership Eligibility Processor who can work from home. The role includes processing enrollment applications, maintaining eligibility records, and providing excellent customer service. Candidates should have a high school diploma...Remote jobHourly payWork from home$18.25 - $24 per hour
A healthcare company is seeking a Membership Eligibility Processor to handle enrollment applications and maintain eligibility records. The ideal candidate will have a high school diploma and data entry experience. Responsibilities include processing applications, ensuring...Remote jobHourly payWork from homeFlexible hours- ...Banner Health is seeking a Grievance & Appeals Coordinator to manage the intake, review, investigation, and resolution of member grievances... ..., detailed documentation, and timely correspondence in a remote setting with Arizona residency required. The incumbent will...Remote work
- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
- ...A-Line is seeking a Remote Appeals Coordinator to support processing of Medicare member and provider appeals and grievances. The role screens for urgency, benefit coverage, and medical necessity, routing cases to the appropriate analyst. Responsibilities include investigations...Remote work
- A health care organization is looking for a Membership Eligibility Processor to manage subscriber eligibility and application processing. This role requires at least a high school diploma and 6 months of data entry experience. Key responsibilities include maintaining accurate...Remote jobWork at officeWork from homeFlexible hours
- ...Ensemble Health Partners is seeking a remote Eligibility Specialist to support uninsured/under-insured patient programs across the United States. The role requires reviewing applications, coordinating submissions, and ensuring timely billing while traveling to client sites...Remote work
- ...RemoteJobsOne invites VA Eligibility Specialists to help evaluate and improve AI systems on veterans health care topics. You’ll use enrollment and eligibility experience to check that questions sound like real veterans and families, and that answers are correct and useful...Remote workContract work
- ...The Association of American Medical Colleges (AAMC) seeks a remote-eligible Engagement Coordinator to support AAHCI activities and member engagement. You will coordinate programs, manage virtual meetings, and assist with registrations and materials. Minimum education...Remote work
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