Roles: Appeals and Grievance Case Resolution Specialist
Start a rewarding career in healthcare support. This entry-level role offers full training, so no prior experience is necessary — just a helpful attitude and good attention to detail.
You will guide member and provider cases from intake through resolution. Working with a supportive team, you will review case information, gather missing details, prepare case files, track progress, and send clear determination and acknowledgement letters.
What you will do:
• Review case documents such as benefit coverage, prior authorizations, and claims
• Contact members and providers by phone and email to clarify details and collect information
• Keep case files complete, accurate, and organized
• Work with other departments to gather what is needed to resolve cases
• Document all activities and outcomes in the case management system
• Handle information confidentially and follow privacy rules
Skills/background needed:
• High school diploma or equivalent required
• Comfortable using Microsoft Word, Excel, and Outlook
• Strong attention to detail and organization
• Good written and verbal communication
• Ability to manage several priorities at once
• Helpful, professional customer service manner
• Full training provided — no experience necessary
Work format: Fully remote work from home. A reliable high-speed internet connection is needed.
Rate: Competitive entry-level pay, details shared upon application.
Location: Remote work worldwide (United States preferred)
Ready to get started? Submit your application below.