2mo
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Supervisor Appeals
Philadelphia, Pennsylvania, United States
OnsiteFull Time
3+ YOEBachelor’s or equivalent experience; minimum 3 years appeals/health plan/operations experience (5 years if no degree); prior appeals/regulatory experience required; leadership preferred; knowledge of PA Act 146 and NCQA.
1w
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Supervisory Appeals Officer
Birmingham or Phoenix or Tucson or Fresno or Lake Forest or Long Beach or Los Angeles or Sacramento or San Bernardino or San Diego or San Francisco or San Jose or Denver or Hartford or New Haven or Washington or Jacksonville or Miami or Plantation or Tampa or Atlanta or Des Moines or Chicago or Indianapolis or Florence or Louisville or New Orleans or Andover or Boston or Baltimore or Lanham or Detroit or Grand Rapids or Saint Paul or Kansas City or Saint Louis or Jackson or Charlotte or Greensboro or Omaha or Portsmouth or Newark or Albuquerque or Las Vegas or Buffalo or Holtsville or New York or Westbury or Cincinnati or Columbus or Independence or Oklahoma City or Portland or Philadelphia or Pittsburgh or Columbia or Memphis or Nashville or Austin or Farmers Branch or Houston or San Antonio or Ogden or Salt Lake City or Richmond or Seattle or Milwaukee
$126k-$197k/yr OnsiteFull Time
1+ YOESupervisory experience with appeals or similar program; applying tax law, dispute resolution, legal research, management techniques, and negotiation to resolve tax appeals.
1w
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APPEALS SPECIALIST
Las Vegas, Nevada, United States
$22-$29/hr OnsiteFull Time
2+ YOE2 years healthcare/collections experience, high school diploma or equivalent, track and resolve appeals, collaborate with clinical auditors, apply critical thinking and attention to detail.
1w
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Supervisor, Appeals
California or Georgia or Tennessee or Nebraska or Wisconsin or Ohio or Arizona or Michigan or Florida or Washington or Arkansas or Illinois or Nevada or Alabama or New Mexico or Pennsylvania or Iowa or Colorado or Oregon or Missouri or Texas or New Hampshire or Kentucky or Oklahoma
$75k-$135k/yr RemoteFull Time
4+ YOEGraduate of accredited nursing program or bachelor's, active RN licensure (state or compact), 4+ years related experience, knowledge of appeals and utilization management, ability to supervise and improve UM processes.
1mo
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Appeals Specialist
Atlanta, Georgia, United States
OnsiteFull Time
3+ YOEHigh school diploma required; minimum 3 years e-billing and appeals experience in an insurance defense law firm preferred. Aderant experience required; BillBlast preferred. Strong analytical, communication, and time-management skills.
Aderant, BillBlast
1mo
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Appeals Professional
Austin or United States
RemoteFull Time
1+ YOEAssociate's degree (or 60+ credits) in healthcare or related, or equivalent experience; 1+ year Medicare appeals/medical review/clinical or healthcare compliance experience; ability to review medical records, make independent decisions, and research regulations.
1mo
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Appeals Professional
Austin or United States
RemoteFull Time
1+ YOEAssociate's degree or 60+ credits in healthcare (or equivalent experience), 1+ year Medicare appeals/medical review/clinical/regulatory experience, US residency 3 of last 5 years, ability to review records and write impartial decisions.
4d
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Specialist, Appeals & Grievances
United States or Bothell or Long Beach
$22-$37/hr RemoteFull Time
2+ YOE2+ years managed care or claims/appeals experience, knowledge of Medicaid/Medicare denials and appeals, strong written/verbal communication, Microsoft Office proficiency.
Microsoft Office
1w
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Supervisor, Appeals - Michigan
Flint, Michigan, United States
HybridFull Time
2+ YOE2+ MgmtSupervisory experience in HMO/managed care appeals and grievances, policy and workflow development, reporting for regulators, staff training, and compliance with NCQA/state requirements.
1mo
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Appeals Representative II
Fort Worth, Texas, United States
$20-$30/hr RemoteFull Time
1+ YOEReview and analyze appeal documentation; HIPAA compliance; knowledge of Medicare/Medicaid; 1+ year healthcare/claims or customer service; strong communication; remote work capability.
Microsoft Office
3d
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Senior Appeals Specialist
Richland County, South Carolina, United States
$50k-$62k/yr OnsiteFull Time
4+ YOEAssociate degree or 4+ years appeals specialist experience; working knowledge of C-Track and SCACR; Microsoft Office proficiency; courtroom/legal experience; ability to lift records >20 lbs.
C-Track, Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, scanners, fax machines, postage machines, copiers
3w
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Appeals Audit Specialist
Grand Blanc, Michigan, United States
OnsiteFull Time
5+ YOE5+ years healthcare experience; RHIT, LPN, hospital biller or associate degree required. Must process and appeal payer denials, write appeals using medical record documentation, and support audits and denial trend analysis.
2mo
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Appeals Representative I
Wilkes-Barre, Pennsylvania, United States
OnsiteFull Time
Handle healthcare appeals; review docs; communicate with patients and providers; ensure timely resolution.
Case Management Software, Healthcare Information Systems
3d
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Manager, Appeals-Alight Leave Solutions
United States
$80k-$90k/yr RemoteFull Time
5+ YOE3+ MgmtLead appeals operations for STD/LTD, 5+ years claims/appeals, 3+ years leadership in absence management, Lean Six Sigma, DMEC training/certification, healthcare/rehab experience, experience managing ~40 staff.
2mo
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Appeals Specialist I
Clearwater, Florida, United States
$20-$23/hr OnsiteFull Time
Experience in medical billing or revenue cycle management; knowledge of insurance guidelines and appeal processes; strong communication; able to work independently and manage priorities.
4d
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Eligibility Appeals Supervisor
Richmond, Virginia, United States
$119k-$131k/yr OnsiteFull Time
Considerable experience leading teams, applying administrative law and appeals procedures, legal research, legal analysis and writing, MS Office proficiency, and stakeholder management.
Microsoft Office, E-Verify
1d
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Appeals Nurse Consultant
Connecticut, United States
$67k-$143k/yr RemoteFull Time
3+ YOEActive unrestricted RN in state of residence, 3+ years clinical experience, associate degree minimum, experience in appeals/managed care preferred, strong communication and multitasking.
1w
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Insurance Appeals Rep
Houston, Texas, United States
OnsiteFull Time
2+ YOEReview clinical documentation and payer guidelines to draft appeals; 2+ years hospital denials experience, Epic HB required, Microsoft Excel, strong research and communication skills.
Epic HB, Microsoft Excel
2mo
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Supervisor Appeals in Philadelphia, Pennsylvania
Philadelphia, Pennsylvania, United States
OnsiteFull Time
3+ YOE1+ MgmtLeadership of administrative appeals team; NCQA/state compliance; PA Act 146 knowledge; vendor and cross‑department collaboration.
1mo
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INSURANCE APPEALS ASSOC
Knoxville, Tennessee, United States
OnsiteFull Time
2+ YOE2 years hospital billing or insurance pre-cert experience required; familiarity with Medicare/Medicaid/commercial payer rules, denials analysis, appeals processing, documentation, and computer proficiency.
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