Appeals & Grievance Specialist (remote)
This is a remote position open to any qualified applicant in the United States.
Job Summary:
We are seeking a dedicated Appeals & Grievance Specialist with 2 to 3 years of experience to join our team. The ideal candidate will have strong technical skills in MS Excel and preferably experience in IVR and Healthcare Call Center domains. This is a work-from-home position with day shifts and no travel is required. The role involves managing and optimizing healthcare processes to improve efficiency and patient satisfaction.
Responsibilities:
Reviewing available Appeals & Grievances for the pending claims to verify due process was followed.
Determine if the appeal or Grievance is legitimate.
A strong understanding of Claims, Appeals and Medical Benefits.
Referring suspicious or complicated Claims to investigators.
Collaborating with other professionals to determine the urgency on the Appeal validity and cause.
Manage and optimize healthcare processes to ensure efficiency and patient satisfaction.
Utilize MS Excel to analyze and interpret data creating reports and dashboards for better decision-making.
Communicate effectively with team members and other departments to ensure seamless operations.
Contribute to the overall success of the company by enhancing patient satisfaction and operational efficiency.
Qualifications:
High School Diploma or GED is Required.
Proficiency in computer skills including typing speed and accuracy
Good written and verbal communication skills
Ability to maintain a high level of integrity and confidentiality of medical information
Knowledge of data entry and transcription
Salary and Other Compensation:
Applications will be accepted until September 6, 2025.
The hourly rate for this position is between $17.00 – 18.00 per hour, depending on experience and other qualifications of the successful candidate.
This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.
Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
• Medical/Dental/Vision/Life Insurance
• Paid holidays plus Paid Time Off
• 401(k) plan and contributions
• Long-term/Short-term Disability
• Paid Parental Leave
• Employee Stock Purchase Plan
Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this
posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
...Benefits Generous CME time and money Supportive Transition Bonus Job Description Join an established group of 10 Orthopedic Surgeons and 15 Advanced Practice Clinicians General Orthopedic Call Required- Dedicated Hospitalist for weekday coverage, shared call...
...As a Security Guard, you will serve and safeguard clients in a range of industries such as Commercial Real Estate, Healthcare, Education, Government and more. Part Time Overnight Security Guard. Pay Rate: $23.30/hr Responsibilities:Provide customer s Security Guard, Part...
...Job Description: Company Description: McDonalds is proud to be one of the most recognized brands in the world, with restaurants... ...ambition is why McDonalds remains one of the worlds leading corporations after almost 70 years. Joining McDonald's means thinking big and...
Overview To provide diagnostic Computed Tomography Services to inpatients, outpatients, and Emergency Department patients under the direction of the supervising radiologist in accordance with established operating procedures and clinical protocols. To provide safe, prompt...
...Motel 6 Santa Ana CA is looking for a Housekeeper. Housekeeper Duties and Responsibilities: A Housekeeper needs to clean the work area to the standards of their employer. This requires attention to detail, physical strength, and the stamina to work long shifts. Here...