Top 756 Appeals representative associate Jobs

Dispute Resolution Reviewer III (Healthcare Professional)
TMF Health Quality Institute —Remote
- Full-time
- Remote
- Writing skills
- Research
- Mid-level
- AD&D insurance
- Disability insurance
Litigation Attorney - Personal Injury
Christina Pendleton and Associates —Hampton, VA
- $100,000 - $125,000 a year
- Full-time
- Background check
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- Health insurance
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Senior Trial Associate- US Virgin Islands
Fischer Redavid PLLC —Remote
- $95,000 - $120,000 a year
- Full-time
- Hybrid work
- Travel
- Senior level
- Under 1 year
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Senior Litigation Associate Attorney, (Employment Law) (Hybrid)
Abramson Labor Group —Burbank, CA
- $180,000 - $250,000 a year
- Full-time
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- Writing skills
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Litigation Attorney - Personal Injury
Christina Pendleton and Associates —Norfolk, VA
- $100,000 - $125,000 a year
- Full-time
- Background check
- Microsoft Excel
- 5 years
- Health insurance
- Dental insurance
Quick Apply
Property Manager
UMOS —Jefferson, WI
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- Weekends as needed
- Carpentry
- Spanish
- Microsoft Excel
- Health savings account
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Litigation Attorney - Personal Injury
Christina Pendleton and Associates —Richmond, VA
- $100,000 - $125,000 a year
- Full-time
- Background check
- Microsoft Excel
- 5 years
- Health insurance
- Dental insurance
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Administrative Assistant - Social Security Disability Claims
Duncan Disability Law, SC —Nekoosa, WI
- From $16 an hour
- Full-time
- Office
- Administrative experience
- Data entry
- Dental insurance
- Paid time off
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7d
Sales Manager - Conventional Housing
Coastal Ridge Real Estate —Columbus, OH
- $60,000 - $70,000 a year
- Office
- High school diploma or GED
- Bachelor's degree
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13d
CDOC - State Teacher I - Welding Instructor (Buena Vista)
State of Colorado —Chaffee County, CO
- $6,022 - $9,636 a month
- Online Application
- Microsoft Word
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- Clean driving record
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CP - Regional Sales Director (RSD)
Century Park Associates —Seattle, WA
- $105,000 - $120,000 a year
- Full-time
- English
- Mid-level
- 3 years
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Advancement Associate—2026-2027
Friends Academy —Locust Valley, NY
- $20 - $23 an hour
- Overtime
- Background check
- School experience
- Google Workspace
- 403(b) matching
- Health savings account
Quick Apply
TRANSITIONS OF CARE, RN
AllCare Health —Grants Pass, OR
- $43 - $45 an hour
- Full-time
- Nursing
- RN License
- Word processing
- Mileage reimbursement
- Health insurance
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Medical Billing Accounts Receivable Specialist
CH Revenue Management Solutions —Red Bank, NJ
- From $27 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Assistant Property Manager
Impact Management Group —Saukville, WI
- $25 - $28 an hour
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- Ability to walk for extended periods
- Health insurance
- Dental insurance
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3h
Insurance and Denials Specialist
Careers at Gentell —Morrisville, PA
- $23 - $25 an hour
- Full-time
- Customer service
- Research
- Mid-level
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Medical Billing Representative
First State Orthopaedics —Newark, DE
- $18 - $23 an hour
- Full-time
- High school diploma or GED
- Computer skills
- In-person
- Health insurance
- Dental insurance
Quick Apply
Member Service Representative
Champion Health Plan/ Champion Payer Solutions —Long Beach, CA
- From $22 an hour
- Weekends as needed
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Activities Assistant (Life Enrichment Leader)
Lakes at Litchfield —Pawleys Island, SC
- $16.63 an hour
- CPR Certification
- Skilled nursing facility
- English
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Senior Medical Biller/Coder
Apollo Anesthesia Associates —Los Angeles, CA
- $32 - $40 an hour
- Full-time
- Google Workspace
- Writing skills
- HIPAA
- Health insurance
- Dental insurance
Quick Apply

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Dispute Resolution Reviewer III (Healthcare Professional)

TMF Health Quality Institute -
Remote

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Job Details

Full-time

Benefits

License reimbursement
AD&D insurance
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Vision insurance
Life insurance

Qualifications

Research

Full Job Description

Category: Program Management

Requisition Number: DRRII001384

Posting Details

- Posted: June 4, 2026
Full-Time
Locations

Remote, Anywhere USA

Job Details

Description

**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**

*This position is located Remote United States*

Position Purpose:

Provides dissatisfied patients/beneficiaries and/or providers the opportunity to present documentation to demonstrate why an appeal/dispute should be allowed. Provides an independent second level determination/dispute resolution based on the documentation, facts, laws, regulations, and guidelines.

Essential Responsibilities:

Reviews medical records/case file, writes a reconsideration/dispute resolution decision that is clear, concise, and impartial and supports the determination made, and documents review.
Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy.
Responds to and ensures that all appeal/dispute issues raised by the beneficiary/patient, representative, and provider/supplier have been addressed.
Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures.
Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision.
Stays abreast of changes in regulations, medical and healthcare practices, policies and procedures.

Minimum Qualifications

Education

Associate's degree or 60 or more credit hours towards a Bachelor’s degree from an accredited college or university in healthcare or related discipline
- Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for Associate’s degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.)

Experience

Three (3) years of medical dispute resolution or Medicare appeals, medical review, clinical, or related experience in a healthcare setting
Healthcare Professional with Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience
- Juris Doctorate or Master’s Degree in Healthcare or related discipline may be substituted for Healthcare Professional with Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience

Demonstrated experience writing or making appeal or payment determinations
Independent Dispute Resolution, preferred
Resided in the United States for a minimum of three (3) years out of the last five (5) years (Per Contract Requirement)

Benefits

C2C offers an excellent benefits package, including:

Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
Section 125 plan
401K
Competitive salary
License/credentials reimbursement
Tuition Reimbursement

EOE Vet/Disability

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Apply Now

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