Top 7 Claims letter correspondence Jobs in Columbus

Appeals and Grievances Specialist
Sidecar Health —Columbus, OH
- $65,000 - $75,000 a year
- Remote
- Mid-level
- 3 years
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply
5d
Homecare - Revenue Cycle Manager – Remote
PurposeCare —Columbus, OH
- $80,000 - $95,000 a year
- On call
- Travel
- Home Health
- Organizational skills
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Human Resources Coordinator
ST VINCENT FAMILY SERVICES —Columbus, OH
- Weekends as needed
- Hybrid work
- Microsoft Outlook
- Mid-level
- Office
- Paid time off
- 401(k) matching
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Industrial Hygienist
US Occupational Safety and Health Administration —Columbus, OH
- $61,722 - $101,375 a year
- Online Application
- Hybrid work
- Background check
- Up to 50% travel
- Bachelor of Science
1d
Roofing Inspector
Simon Roofing —Columbus, OH
- $50,000 - $70,000 a year
- Full-time
- Customer service
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply

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Appeals and Grievances Specialist
Sidecar Health —Columbus, OH
Bachelor's degree required, in a relevant field such as healthcare administration, business, public health, or a related discipline.
$65,000 - $75,000 a year
Quick Apply
5d
Homecare - Revenue Cycle Manager – Remote
PurposeCare —Columbus, OH
Bachelor's degree in finance, accounting, business, healthcare, or related field. Supervises payment posting, reconciling remittance posting in EMR to balance…
$80,000 - $95,000 a year
Quick Apply

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Appeals and Grievances Specialist

Sidecar Health -
Columbus, OH

Quick Apply

Job Details

$65,000 - $75,000 a year
5 days ago

Benefits

Paid holidays
Health insurance
Dental insurance
401(k)
Vision insurance

Qualifications

Affordable Care Act (ACA)
Caseload management
Health insurance policy knowledge
Regulatory compliance in claims processing
State healthcare regulations
Bachelor's degree
Insurance regulation
Cross-functional collaboration
Cross-functional communication

Full Job Description

Sidecar Health is redefining health insurance. Our mission is to make excellent healthcare affordable and accessible for everyone. We know that to accomplish this lofty mission, we need driven people who will make things happen.

The passionate people who make up Sidecar Health's team come from all over, with backgrounds as tech leaders, policy makers, healthcare professionals, and beyond. And they all have one thing in common—the desire to fix a broken system and make it more personalized, affordable, and transparent.

If you want to use your talents to transform healthcare in the United States, come join us!

About the Role

As an Appeals and Grievances Specialist, you'll own the end-to-end handling of member and provider appeals and grievances, investigating cases, coordinating with internal teams, and delivering clear, well-reasoned resolutions within regulatory timelines.

This role sits at the intersection of advocacy, compliance, and operations. You'll work directly with members and providers who need someone to take their concern seriously, dig into the details, and get them an answer they can trust. You'll report to the Director, Quality and Continuous Improvement, and work closely with QA, Claims, Clinical, and Provider Relations to reach fair, well-documented outcomes.

What You'll Do

Intake, triage, and manage a caseload of member and provider appeals and grievances from submission through resolution
Investigate each case thoroughly, reviewing claims history, benefit determinations, clinical documentation, and prior correspondence
Apply plan documents, state and federal regulations, and Sidecar Health policy to reach accurate, well-documented determinations
Draft clear, compliant resolution letters and member and provider communications in Sidecar Health's brand voice
Track all cases and deadlines to ensure compliance with state and federal turnaround time requirements
Coordinate with Claims, Clinical, Provider Relations, and Legal teams to gather information and resolve complex cases
Identify escalation risks and loop in leadership or the Grievance Committee when a case requires second-level review
Spot patterns in appeals and grievances that point to upstream process, system, or communication issues, and flag them to leadership
Maintain accurate records in the case management system to support audits and regulatory reporting
Contribute to process improvements, SOP updates, and knowledge base articles for the appeals and grievance's function

What You'll Bring

Bachelor's degree required, in a relevant field such as healthcare administration, business, public health, or a related discipline
3+ years of experience in appeals and grievances, claims adjudication, utilization review, or a related health insurance operations role
Working knowledge of health insurance regulatory requirements for appeals and grievances (state DOI requirements, ERISA, ACA as applicable)
Strong analytical skills, comfortable reading claims data, plan documents, and clinical notes to form a defensible conclusion
Excellent written communication skills; able to explain complex determination in plain, empathetic language
A track record of managing a caseload independently and meeting hard deadlines
Comfort working across systems and teams to track down the information a case needs
A member-first mindset, balanced with rigorous attention to policy and compliance

Nice to haves

Experience with Genesys Cloud, Salesforce, or similar case management and CRM platforms
Familiarity with Medicare Advantage or ACA marketplace appeals processes
Prior experience in a fast-growing or start-up health insurance environment

What You'll Get

Competitive salary ($65,000 - $75,000), bonus opportunity, and equity package
Comprehensive Medical, Dental, and Vision benefits
A 401k retirement plan
Paid vacation and company holidays
Opportunity to make an impact at a rapidly growing mission-driven company transforming healthcare in the U.S.

Sidecar Health is an Equal Opportunity employer committed to building a diverse team. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.

Quick Apply

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claims letter correspondence jobs in columbus

Appeals and Grievances Specialist

Homecare - Revenue Cycle Manager – Remote

Human Resources Coordinator

Industrial Hygienist

Roofing Inspector

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