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Grievance and appeals specialist Jobs

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173 grievance and appeals specialist Jobs

  • Healthfirst Logo3.4
    Healthfirst
    Appeals and Grievances Specialist, Non Clinical
    Lake Mary, FL
    23d
    The A&G Specialist is the subject matter expert responsible for non-clinical case development and case
  • AG Globe Services Logo3.1
    Appeals and Grievance Specialist I
    Irving, TX
    $45K - $62K (Glassdoor est.)
    Easy Apply
    2d
    Role: Appeals and Grievance Specialist II
    Location: Irving, TX
    Contract:
  • Employment Training Specialist (Job Coach)
    Waterford, MI
    Easy Apply
    16d
    Has knowledge of individual and employee Grievance and Appeals process, and communicates employee rights to the individuals…Employment Training Specialists are responsible for providing direct care services that empower, teach, train, and guide the individuals served…
  • Assoc Specialist, Appeals & Grievances
    Midvale, UT
    Easy Apply
    1d
    Job Description Job Summary Molina Healthcare's Appeals & Grievances jobs are responsible for reviewing and resolving member complaints…Determines appropriate language for letters and prepare responses to appeals and grievances
  • Healthfirst Logo3.4
    Clinical Specialist, Dental Appeals and Grievances
    Lake Mary, FL
    $38K - $86K (Glassdoor est.)
    13d
    Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member…: Bachelor’s degree Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management…
  • Commonwealth Care Alliance Logo3.5
    Appeals & Grievances Program Advisor
    Boston, MA
    $37K - $70K (Glassdoor est.)
    14d
    Why This Role is Important to Us Appeals and Grievances Program Specialist supports the operations of the Appeals and Grievances department through many NCQA and other related quality program… We're Looking For Associate's Degree or equivalent experience in Appeals and Grievances Preferred Experience: Bachelor's Degree (B.S. or B.A…
  • Healthfirst Logo3.4
    Appeals and Grievances Nurse, RN or LPN
    Lake Mary, FL
    23d
    : Bachelor’s degree Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management…The A&G Clinical Specialist RN or LPN is the subject matter expert responsible for all clinical case development and case resolution while ensuring compliance with Federal…
  • Loan Registration Specialist
    San Diego, CA
    $29K - $51K (Glassdoor est.)
    Easy Apply
    4d
    protected against retaliation if they engage in a protected activity, whistleblowing, or the exercise of any appeal or grievance right provided by law. …-time opportunity for a Loan Registration Specialist with our San Diego, CA Correspondent Channel! …
  • AltaStaff Logo3.2
    Clinical Appeals Specialist
    Chicago, IL
    Easy Apply
    8d
    AltaStaff is looking for an Appeals Specialist in or near Boone, Carroll, Stephenson, Winnebago, or Jo Davies Counties to review denials and appeals…Summary Manages submission, intervention and resolution of appeals, grievances
  • Healthfirst Logo3.4
    Regulatory Specialist
    Lake Mary, FL
    $36K - $73K (Glassdoor est.)
    23d
    Review organization and coverage determinations, appeal, and grievances to ensure benefits are administered in accordance to State and Federal regulations…The Clinical Regulatory Specialist is responsible for promoting compliance with the regulatory requirements within Healthfirst's delegated vendors…
  • Network Health Logo3.1
    Appeals and Grievances Specialist I (24 hrs/week)
    Menasha, WI
    $35K - $68K (Glassdoor est.)
    24h
    Network Health is seeking a compassionate Part-time Appeals and Grievances Specialist to deliver swift, accurate, and fair investigations of member appeals and grievances…Our Part-time Appeals and Grievances Specialist will review appeals and grievances filed…
  • Appeals and Grievances Specialist I
    Irving, TX
    Easy Apply
    22d
    Responsible for analyzing, researching, and managing appeal/grievance inventories from members and providers…Review and respond to complaints, grievances and appeals within the stated time frame for each request. ? …
  • Memorial Health System Logo4
    Insurance Pre-Authorization Specialist I
    Springfield, IL
    $32K - $52K (Glassdoor est.)
    Easy Apply
    16d
    May provide direction to patients on the appropriate appeal procedures for denials… of Public Health grievance process as appropriate. …
  • Financial Additions Logo4.6
    Appeals & Grievance Specialist
    Irving, TX
    Easy Apply
    25d
    Financial Additions has partnered with a healthcare provider in search of an Appeals & Grievance Specialist…Review and respond to complaints, grievances and appeals within the stated time frame for each request…
  • Member Care Specialist I/II
    San Rafael, CA
    Easy Apply
    4d
    Advocating on behalf of members with health plan disputes by assisting with appeals and grievances The successful candidate…
  • Human Interest Logo3.5
    Escalations Specialist
    California
    Easy Apply
    28d
    or more years of experience in a Team Lead, Quality, Appeals & Grievances, or similar position Understanding of SaaS business…
  • AG Globe Services Logo3.1
    Appeals and Grievances Specialist II
    Irving, TX
    Easy Apply
    25d
    Role: Appeals and Grievances Specialist II Location: Irving, TX Contract: Temp to Permanent Work Schedule: Day…Review and respond to complaints, grievances and appeals within the stated time frame for each request. …
  • Molina Healthcare Logo3.5
    Post-Service Specialist, Appeals & Grievances-Medicare
    Long Beach, CA
    $12 - $18 Per Hour(Glassdoor est.)
    20d
    Job Description Job Summary CST or EST Zones Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member…Job Description Job Summary Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints…
  • Devoted Health Logo4.5
    Appeals & Grievances Specialist
    Waltham, MA
    20d
    : The Appeals & Grievances Specialist is responsible for ensuring professional handling of all member and provider appeals and grievances in a timely and efficient way…This role is also responsible for the accurate coordination, efficient administration and resolution of member appeals, provider appeals and member grievances submitted by Devoted Health Plan members or providers…
  • Medical Billing - Grievance and Appeals Specialist
    Dallas, TX
    $32K - $54K (Glassdoor est.)
    Easy Apply
    1d
    Looking for a highly motivated person with knowledge of medical billing and appeal process to call on appeals and work to get them paid…Will train employee on what questions to ask in order to get appeals paid. …
  • TotalMed Staffing Logo4.1
    Grievance and Appeals Coordinator
    San Jose, CA
    Easy Apply
    17d
    Act as a back-up to the Grievance and Appeals Intake Specialist during times of high volume work…Job Duties: The Grievance and Appeals Coordinator is responsible for the beginning-to-end process of receiving, researching and resolving of new and existing member and provider grievance and appeals cases…
  • Devoted Health Logo4.5
    Appeals & Grievances Supervisor
    New Gloucester, ME
    $51K - $125K (Glassdoor est.)
    23d
    The Supervisor will lead the team of Appeals & Grievances specialists who review feedback and appeals…In this role, you will be managing and supporting A&G specialists to be successful in providing excellent handling of appeal and grievance cases, including…
  • GlobalHealth Logo4.3
    Appeals & Grievances Specialist
    Oklahoma City, OK
    Easy Apply
    10d
    : Assist in the investigation for all Member and Provider appeals and/or grievances Call members and providers to determine the root cause of their issue… compliance team Inform the member of the resolution of the issue via call or letter Inform management of training opportunities for coworkers to help prevent future appeals and grievances Make outbound…
  • AllyAlign Health Logo4.5
    Appeals and Grievances Specialist
    Glen Allen, VA
    Easy Apply
    22d
    AllyAlign Health is looking for a qualified candidate to be a key member of our Medicare Advantage Appeals & Grievances team, as a Specialist…Reporting to the Manager, Appeals & Grievances. …Job Summary: The Appeals & Grievances Specialist manages, investigates, and resolves member and provider appeals and grievances
  • New York Life Insurance Co Logo3.9
    Senior Associate, Claims Appeals and Grievances Specialist
    Pittsburgh, PA
    $52K - $115K (Glassdoor est.)
    2d
    GBS2021 Manages the administrative appeal process and the formal grievance process to ensure the resolution of grievances and appeals consistent with organizational policies and procedures…Most senior non-management claims examiner position, responsible for rendering a final claim determination on the complex appealed cases…
  • Molina Healthcare Logo3.5
    Appeals & Grievances Specialist - Marketplace
    Irving, TX
    9d
    . 1 year grievance and appeal experience and 1 year managed care customer service experience. …Preferred Experience 1+ years grievance and appeal experience. …
  • Molina Healthcare Logo3.5
    Specialist, Appeals - Member Appeals & Grievances
    Richmond, VA
    $20K - $35K (Glassdoor est.)
    9d
    KNOWLEDGE, SKILLS & ABILITIES : Responsible for submission, intervention and resolution of appeals, grievances…Ability to prioritize, work under pressure, while maintaining organization and meeting appeals and grievances deadlines.JOB FUNCTION…
  • Molina Healthcare Logo3.5
    Specialist, Appeals & Grievances
    Milwaukee, WI
    15d
    ) : Responsible for submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members and related outside agencies…. for presentations and audits.J OB F UN C T I ON: Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible…
  • Devoted Health Logo4.5
    Appeals & Grievances Intake Coordinator
    New Gloucester, ME
    $33K - $55K (Glassdoor est.)
    23d
    We view moments where members share feedback with us, informally or through our Appeals and Grievances process, as particularly important to that mission…As the A&G Intake Coordinator you will support the operations of the Appeals & Grievances team…
  • Molina Healthcare Logo3.5
    Specialist, Appeals & Grievanc
    Long Beach, CA
    22d
    Job Description Job Summary Responsible for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints…/Abilities Responsible for submission, intervention and resolution of appeals, grievances

Jobs

Job TitleEmployerLocationSalary
Appeals and Grievances Specialist, Non ClinicalHealthfirstLake Mary, FL
Appeals and Grievance Specialist IAG Globe ServicesIrving, TX
Employment Training Specialist (Job Coach)Employment Options UnlimitedWaterford, MI
Assoc Specialist, Appeals & GrievancesMolina HealthcareMidvale, UT
Clinical Specialist, Dental Appeals and GrievancesHealthfirstLake Mary, FL
Appeals & Grievances Program AdvisorCommonwealth Care AllianceBoston, MA
Appeals and Grievances Nurse, RN or LPNHealthfirstLake Mary, FL
Loan Registration SpecialistPlaza Home MortgageSan Diego, CA
Clinical Appeals SpecialistAltaStaffChicago, IL
Regulatory SpecialistHealthfirstLake Mary, FL
Appeals and Grievances Specialist I (24 hrs/week)Network HealthMenasha, WI
Appeals and Grievances Specialist IInfiIrving, TX
Insurance Pre-Authorization Specialist IMemorial Health SystemSpringfield, IL
Appeals & Grievance SpecialistFinancial AdditionsIrving, TX
Member Care Specialist I/IICareCounselSan Rafael, CA
Escalations SpecialistHuman InterestCalifornia
Appeals and Grievances Specialist IIAG Globe ServicesIrving, TX
Post-Service Specialist, Appeals & Grievances-MedicareMolina HealthcareLong Beach, CA
Appeals & Grievances SpecialistDevoted HealthWaltham, MA
Medical Billing - Grievance and Appeals SpecialistSuperior Medical ManagementDallas, TX
Grievance and Appeals CoordinatorTotalMed StaffingSan Jose, CA
Appeals & Grievances SupervisorDevoted HealthNew Gloucester, ME
Appeals & Grievances SpecialistGlobalHealthOklahoma City, OK
Appeals and Grievances SpecialistAllyAlign HealthGlen Allen, VA
Senior Associate, Claims Appeals and Grievances SpecialistNew York Life Insurance CoPittsburgh, PA
Appeals & Grievances Specialist - MarketplaceMolina HealthcareIrving, TX
Specialist, Appeals - Member Appeals & GrievancesMolina HealthcareRichmond, VA
Specialist, Appeals & GrievancesMolina HealthcareMilwaukee, WI
Appeals & Grievances Intake CoordinatorDevoted HealthNew Gloucester, ME
Specialist, Appeals & GrievancMolina HealthcareLong Beach, CA
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