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Medical Director- South Central - Remote | WFH (Laguna Niguel)

Get It Recruit - Healthcare Laguna Niguel California United States
(No Timezone Provided)

Your role will be pivotal in ensuring regulatory compliance while leveraging diverse resources such as national clinical guidelines, CMS policies, and internal reference materials to make informed decisions. Responsibilities: Review moderately complex to complex clinical scenarios through computer-b...

Transcription Team Member - Work from Home (Laguna Niguel)

Qonten Laguna Niguel California United States
(No Timezone Provided)

**Transcription Team Member - Work from Home** - | Sat, 05 Feb 2022 13:09:34 GMT Participates in programs and in using tools in support of building a high performance culture via the standard Sutter Shared Services responsibilities (e.g. Helps foster an environment in which continuous improvement i...

Grievance/Appeals Analyst Sr

Elevance Health Atlanta Georgia United States
(No Timezone Provided)

WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, s...

Administrative Appeals Representative (Work From Home)

American Specialty Health Bartlesville Oklahoma United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health New Smyrna Beach Florida United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Saginaw Michigan United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Kansas City Missouri United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Fort Pierce Florida United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Belleville Michigan United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Aberdeen Maryland United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Los Alamos New Mexico United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Avon Park Florida United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Seneca South Carolina United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Denison Texas United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Fort Smith Arkansas United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Carlsbad New Mexico United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Fallon Nevada United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Camden South Carolina United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Albertville Alabama United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Hopkinsville Kentucky United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Winchester Kentucky United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Panama City Beach Florida United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Elko Nevada United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Galveston Texas United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Greeneville Tennessee United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Henderson Kentucky United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Spartanburg South Carolina United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Somerset Kentucky United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Administrative Appeals Representative (Work From Home)

American Specialty Health Destin Florida United States
(No Timezone Provided)

[Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay / Equipment provided - As an Appeals Rep you'll: Prepare appeals/grievances for review by the Review Committees; Read each appeal/grievance to determine what is being requested and what action should be taken; Research issue us...

Complaints and Grievances Coordinator I (Remote)

Home Nursing Agency Greensburg Pennsylvania United States
(No Timezone Provided)

Description UPMC Health Plan is hiring a full-time Complaints and Grievances Coordinator I to help support the Complaints and Grievances Department (Provider Appeals service line). This is a Monday through Friday daylight position. The team is based out of downtown Pittsburgh's US Steel Tower...

Acquisition Specialist (Laguna Niguel)

Confidential Laguna Niguel California United States
(No Timezone Provided)

We are currently seeking an Acquisition Specialist supporting the Naval Health Research Center (NHRC) San Diego. NHRC optimizes the operational readiness and health of our armed forces by conducting research, development, testing, and evaluation to inform Department of Defense (DoD) policy.Duties in...

Complaints Grievances Appeals Liaison Medicare Advantage (Remote)

Oscar Health Tempe Arizona United States
(No Timezone Provided)

Hi, we're Oscar. We’re hiring a Complaints Grievances and Appeals (CGA) Liaison to join our Clinical team in our Tempe office.  Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, t...

Grievance & Appeals Nurse (CA) - Remote Available

Envolve Pharmacy Solutions None null United States
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...

Medical Director- South Central - Remote | WFH (Laguna)

Get It Recruit - Healthcare Laguna New Mexico United States
(No Timezone Provided)

Your role will be pivotal in ensuring regulatory compliance while leveraging diverse resources such as national clinical guidelines, CMS policies, and internal reference materials to make informed decisions. Responsibilities: Review moderately complex to complex clinical scenarios through computer-b...

Telephone Screener (Remote) (Laguna Niguel)

Hire Standard Staffing Laguna Niguel California United States
(No Timezone Provided)

(High Paying) Remote SalesAmerican Income Life (part of Globe Life, a NASDAQ traded company) is looking for Benefit Representatives to help manage growing client needs and help provide both new and existing clients with the best products and services available. This is an opportunity to get a foot i...

Customer Service Representative - Work From Home> (Laguna Niguel)

Garner Health Laguna Niguel California United States
(No Timezone Provided)

[Member Service / Remote] - Anywhere in U.S. / Up to $19 per hour - As a Customer Service Rep you'll: Become an expert on Garner's product, operations, and the needs of members; Deliver amazing service to members via phone, chat, and email; Offer education and guidance to help customers understand a...

Transcription Team Member - Work from Home (Laguna)

Qonten Laguna New Mexico United States
(No Timezone Provided)

**Transcription Team Member - Work from Home** - | Sat, 05 Feb 2022 13:09:34 GMT Participates in programs and in using tools in support of building a high performance culture via the standard Sutter Shared Services responsibilities (e.g. Helps foster an environment in which continuous improvement i...

Sales & Reservations Agent (Work From Home) (Part Time) (Laguna Niguel)

karier.co Laguna Niguel California United States
(No Timezone Provided)

* Provide superb customer service. * Learn and sell the benefits of doing business with U-Haul. * Master required scripts and customer advisements. * Use good time management practices. * Opportunity for base pay merit increases based on performance. * Part-time benefits include: Medical Reimbu...

Appeals Representative - Cypress, CA or WFH

UnitedHealth Group Cypress California United States
(No Timezone Provided)

This role is temporarily remote. Training is conducted virtually from your home. This role is an onsite role and you will transition once training is completed to work in the office in the future. If you are located at Chico, CA, you will have the flexibility to telecommute* (work from home) as you ...

Appeals Representative - Cypress, CA or WFH

UnitedHealth Group Chico California United States
(No Timezone Provided)

This role is temporarily remote. Training is conducted virtually from your home. This role is an onsite role and you will transition once training is completed to work in the office in the future. If you are located at Chico, CA, you will have the flexibility to telecommute* (work from home) as you ...

OptumRx Specialty Consumer Affairs Advocate - Remote

UnitedHealth Group Shawnee Mission Kansas United States
(No Timezone Provided)

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care dat...

OptumRx Specialty Consumer Affairs Advocate - Remote

UnitedHealth Group Atlanta Georgia United States
(No Timezone Provided)

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care dat...

Customer Service Representative - Work From Home (Laguna Niguel)

CVS Health Laguna Niguel California United States
(No Timezone Provided)

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its cent...

After Hours Triage Nurse Full Time (Work From Home), Utah (Laguna Niguel)

Sutter Health Laguna Niguel California United States
(No Timezone Provided)

We are so glad you are interested in joining Sutter Health! Organization: SCAH-Sutter Care at Home - UT Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone support to Sutter Health patients, oth...

Customer Service Representative - Work From Home (Laguna Niguel)

Qonten Laguna Niguel California United States
(No Timezone Provided)

**Customer Service Representative - Work From Home** - | Thu, 02 Sep 2021 09:52:07 GMT Handles provider customer service inquiries and problems via telephone, internet or written correspondence. Handles incoming status requests for appeals and pre-authorizations not handled by Clinical Claim Manage...

Service Manager (Remote) (Laguna Niguel)

Hire Standard Staffing Laguna Niguel California United States
(No Timezone Provided)

(High Paying) Remote SalesAmerican Income Life (part of Globe Life, a NASDAQ traded company) is looking for Benefit Representatives to help manage growing client needs and help provide both new and existing clients with the best products and services available. This is an opportunity to get a foot i...

Development Associate (Laguna Niguel)

W rth Elektronik Group Laguna Niguel California United States
(No Timezone Provided)

Company Description Are you a recent graduate or looking to kickstart a new career path in Field Sales? Wurth Electronik is offering a unique opportunity for self-driven individuals with the right skillset to join our Field Sales internship program in San Diego, CA. This is a full time paid internsh...

Appeals Representative Associate - Remote

UnitedHealth Group Hartford Connecticut United States
(No Timezone Provided)

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless...

Appeals Representative Associate - Remote

UnitedHealth Group Atlanta Georgia United States
(No Timezone Provided)

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless...

Appeals Representative Associate - Remote

UnitedHealth Group Tampa Florida United States
(No Timezone Provided)

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless...