Remote Appeals & Grievances Specialist (RN/LPN/DH)
healthfirstNew York (NY)
Remote Appeals & Grievances Specialist (RN/LPN/DH)
Posted 17 days ago
healthfirstNew York (NY)
SENIORITY
Senior
About the role
A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching issues, and ensuring compliance with regulations. Ideal candidates should have experience in clinical practice and knowledge of Utilization Review Guidelines. The position offers a competitive salary and an opportunity to work with a dynamic team.
Before you apply
Applying takes about a minute. These four things decide how fast it moves after that.
Your profile is current
It's what we read first. Occupations, seniority and locations matter more than a long history.
Two examples you can talk through
Not a portfolio — just two pieces of work where you can explain the decisions and what you'd change.
A number in mind
What you're on now and what would make you move. We negotiate better when we know both.
Your notice period
Employers plan around it, and it's the question that stalls offers most often.
Once you apply, someone reads it and calls you before anything reaches the employer — usually within two working days.
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