20 Best jobs in Remote (Hiring Now!)

Grievance and Appeals Representative(Customer Service)
Confidential —Remote
This associate may screen incoming complaints received orally or in writing, conduct root cause analysis as needed, create an action plan, coordinate and…
Estimated: $16 - $18 an hour
Quick Apply
1h
Junior Full Stack Developer
Red Cedar Consultancy, LLC —Remote
Perform analysis, design, coding, testing, implementation, and maintenance of software solutions. Experience developing in environments that utilize CI/CD tools…
Estimated: From $60,000 a year
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1h
Municipal Water Works Sales Representative - Remote in Minnesota
AMERICAN Cast Iron Pipe Company —Minneapolis, MN
Along with account management, the candidate will travel to build relationships, support products in the field after the sale, consult on specifications for…
Estimated: $60,000 - $100,000 a year
Quick Apply
2h
Quality Assurance Specialist
All In Solutions —Remote
Identifies and maintains the original configuration of requirements documentation, design documentation, software/hardware and related documentation.
Estimated: From $33.25 an hour
Quick Apply
1h
Sales Development Representative
Brian Norusis Inc. —Remote
This is done through a combination of inbound and outbound efforts where you will perform outbound prospecting efforts as well as serve as the main point of…
Estimated: $35,000 - $50,000 a year
Quick Apply
1h
Client Success Specialist
Beyond Finance —Florence, KY
Above all else, provide a helpful and caring customer service experience over high volume inbound and outbound client phone calls of varying complexity by…
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1h
Life Insurance Specialist
Florida Wealth Solutions —Remote
We are a family run insurance agency looking for an insurance specialist with a life and health license (if you do not have a license, we assist with the…
Estimated: $50,000 - $75,000 a year
Quick Apply
1h
Social Media Networking Work from home
accident ask a pro —Houston, TX
Have a license or some form of identification. Work a minimum of 2 hours networking. Participate in conversations, virtual meetings.
Estimated: $25 - $30 an hour
Quick Apply
1h
Laundry and Ironing
iChore, Inc —Remote
Download the iChore Chorer App now and start your independent business. Job Types: Full-time, Part-time.
Estimated: From $15 an hour
Quick Apply
1h
Web Project Manager
Slicedbread —Remote
Willingness to learn almost enough to be an engineer of their own! Because the candidate will be working within technical development environments and projects…
Estimated: Up to $80,000 a year
Quick Apply
1h
Remote Mental Health Provider (LMFT, LICSW, LMHC)
Path Mental Health —Massachusetts
Our Care Coordination team manages Higher Level of Care requests for your clients, and our Quality Team of licensed clinicians leads peer reviews, develops…
Quick Apply
Litigation Attorney (CA License)
Lorber, Greenfield & Polito, LLP —San Francisco Bay Area, CA
Must have superb writing, analysis and supervisoral skills. 4+ year attorney with recent litigation experience. Trial experience a plus, but not mandatory.
Estimated: $80,000 - $135,000 a year
Quick Apply
Patient Services Representative
American Health Connection Inc —Remote
Representatives can expect to handle 100 + calls back-to-back per shift. \*Our healthcare agents must have *private, noise free, HIPAA compliant space at home.*…
Estimated: $16 an hour
Quick Apply
Human Resources Generalist
American Health Connection Inc —Remote
Associate degree in a related field or equivalent combination of education and/or experience. BA / BS in Human Resources or related field preferred.
Estimated: $20 - $25 an hour
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Associate Attorney - First Party Property
Chartwell Law —Remote
Must be admitted to practice in the state of Florida (required), but can be located anywhere within the state of Florida, other states are a plus.
$75,000 - $100,000 a year
Quick Apply
Cloud Data Mesh Lead
Kainergy Consulting —Remote
This role will develop solutions architecture to expedite data mesh onboarding, expand the scope of data sharing on the platform to new technologies, and…
Estimated: $80 - $90 an hour
Quick Apply
Sales Representative, Building Services & Construction
Aggreko, LLC —Richmond, VA
The Sales Representative Commercial, Building Services & Construction is responsible for selling temporary solutions and services focusing on General…
Estimated: $74.7K - $94.6K a year
Attorney
Dennis Hernandez & Associates, P.A. —Remote
Conduct research and analysis of legal problems. The Attorney will be responsible for providing legal advice and counsel to clients, researching and preparing…
Estimated: $90,000 - $150,000 a year
Quick Apply
Vascular Access RN (PICC Nurse) - South Bend, IN - PRN/As Needed
Dynamic Access LLC —South Bend, IN
Driving from client facility to client facility may account for a large part of the usual workday (valid driver’s license is required).
Estimated: $70.1K - $88.8K a year
Quick Apply
Contract Manager -Satellite Communications industry
Baran Agency —Remote
You'll lead and own the company's market development with an emphasis on business growth, market penetration, and cost-effective customer acquisition focused on…
Estimated: $120,000 - $200,000 a year
Quick Apply
1h

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Grievance and Appeals Representative(Customer Service)

Confidential Remote

Quick Apply

Job Details

Contract $16 - $18 an hour 1 hour ago

Qualifications

Bilingual
Spanish
Managed care
Customer service
Microsoft Office
High school diploma or GED
Organizational skills
1 year
Root cause analysis
Communication skills
Time management

Full Job Description

Position: Customer Service Lead Representative

Location: 100 % Remote

Duration: 3-4 Months Contract + High Potential to Extend

Duties:

Candidates can be sourced from across the US as long as they're able to support the CST schedule.
Candidates must have a reliable, high-speed internet connection and have a quiet and private working environment.
Time off will not be approved for the first 8 weeks - any candidates with time off within this time frame will not be able to move forward.
Candidates are expected to arrive on time, every day to work.
After training and once acclimated, workers will be expected to adhere to the below standards.
Metric Driven: Closing 10 cases/day (goal)
Quality Metric: 95% or higher during Audits
DPA %: Needs to be 75% or higher (Active during working hours)
The Grievance team manages ***** Medicare/Medicaid grievances that are presented by our members or their representatives pertaining to the authorization of or delivery of clinical and non-clinical services.
Grievance works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner.
Grievance coordinator position is focused on the processing of Medicare customer grievances.
This associate may screen incoming complaints received orally or in writing, conduct root cause analysis as needed, create an action plan, coordinate and communicate resolutions, as well as document systems in detail with case notes related to Customer grievances with in CMS guidelines.
Grievance Coordinator is responsible for corresponding with members, providers, and regulators regarding decisions and actions.
Works collaboratively with the Claims, Customer Service, Appeals, and Medical Management Departments.
Communicate, collaborate, and cooperate with internal and external business partners.
Adheres to all Compliance/Program Integrity requirements and complies with HIPAA Regulations.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.
Supports department-based goals that contribute to the success of the organization

Skills:

Written communication
Critical Thinking
Microsoft Office Knowledge

Qualifications:

Minimum requirement: 1 year of G&A and/or 1+ year or more of Customer Service at a health insurance company
Bilingual in Spanish is preferred but not required
Strong written and verbal communication skills, PC proficiency to include Microsoft office products.
One year of health insurance/managed care experience performing Appeals and Grievances functions.
Will consider managed care associates with three years of experience in customer service, call center or claims processing skills and knowledge of healthcare delivery.
Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment.
Demonstrated written communication skills, time management, priority setting, problem solving and organizational skills.
Demonstrated ability to converse with and collaborate with physicians and physician personnel.
Ability to identify and define problems, collect data/information, establish facts, and draw valid conclusions and provide resolution.
Ability to track and manage caseload effectively in Grievance tracking system
Must be able to work independently and under pressure related to tight time-frames
One year of health insurance/managed care experience knowledge of healthcare terminology preferable.
Intermediate PC Skills
Previous experience working in a remote setting is preferred

Education:

High school diploma and two years in a Medicare, Medicaid managed care environment investigating and resolving Grievances

Schedule Notes:

Training:

Monday - Friday 8 AM - 5 PM CST
Shifts between Monday - Friday 8 AM- 5 PM CST; candidates can pick their shifts once they are out of training
OT is available once training is complete and candidate performance meets expectations, upon approval
100% WAH - 50 states

Job Type: Contract

Pay: $16.00 - $18.00 per hour

Schedule:

8 hour shift
Day shift
Monday to Friday

Language:

Spanish (Preferred)

Work Location: Remote

Quick Apply

jobs in Remote

Grievance and Appeals Representative(Customer Service)

Junior Full Stack Developer

Municipal Water Works Sales Representative - Remote in Minnesota

Quality Assurance Specialist

Sales Development Representative

Client Success Specialist

Life Insurance Specialist

Social Media Networking Work from home

Laundry and Ironing

Web Project Manager

Remote Mental Health Provider (LMFT, LICSW, LMHC)

Litigation Attorney (CA License)

Patient Services Representative

Human Resources Generalist

Associate Attorney - First Party Property

Cloud Data Mesh Lead

Sales Representative, Building Services & Construction

Attorney

Vascular Access RN (PICC Nurse) - South Bend, IN - PRN/As Needed

Contract Manager -Satellite Communications industry

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