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$60,000–$65,000/yr
US

  • Process incoming requests for first, second level, and external appeals to ensure high customer service and productivity.
  • Review cases to verify appeal qualifications, update case types, and submit information to independent review organizations.
  • Communicate effectively with appeal pharmacists and make outreach attempts to obtain necessary information for case reviews.

HIPAA Compliance Managed Care Communication Skills

20 jobs similar to Appeals Technician

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US

  • Manage month-end and year-end closing processes, reconcile accounts, and oversee daily general ledger activities across multiple ERPs.
  • Conduct financial analysis of key metrics, prepare reports for management decisions, and ensure compliance with US GAAP and internal controls.
  • Assist in budgeting, forecasting, and process improvement initiatives while supporting internal/external audits and providing ad-hoc support to leadership.

Cornerstone Building Brands is a leading manufacturer of exterior building products for residential and low-rise non-residential buildings across North America. With over 18,800 team members and a broad distribution network, the company fosters a culture of corporate stewardship and ESG responsibility, committed to positively impacting its communities.

US

  • Meet and engage with clients remotely over video, chat and email to give guidance on topics like budgeting, student loans, retirement readiness, equity compensation, debt management and more
  • Advise on the LearnLux methodology to improve and respond to the changing financial environment
  • Become an expert on our client’s benefit plans so you can act as an extension of their team during open enrollment

LearnLux provides workplace financial wellbeing, blending fiduciary digital planning with one-on-one guidance from Certified Financial Planner professionals. They are a venture-backed company that has raised over $35M to date and is supported by experienced investors and long-term partners, valuing people who take ownership of their work.

$44,800–$71,000/yr
US

  • Manage the standard credentialing review process for pharmacies.
  • Review exclusion lists to identify any excluded pharmacies.
  • Manage the development and maintenance of a credentialing database.

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have solutions such as Capital Rx and Judi® which consolidates all claim administration-related workflows in one scalable, secure platform.

$24–$38/hr
US

  • Responsible for the oversight and coordination of payer audit requests.
  • Functions as the primary audit liaison for case management and financial services.
  • Keeps audit activity current, moving and prevent the organization from financial burden.

Sanford Health is a large and fast-growing not-for-profit health system in the United States. They offer development and advancement opportunities to their nearly 50,000 employees who are dedicated to health and healing.

Global

  • Assist clients in booking flights, accommodations, and vacation packages tailored to their preferences.
  • Provide personalized travel recommendations using a trusted supplier network and secure discounted rates through booking platforms.
  • Manage client relationships and communication to ensure top-notch customer service while working independently with ongoing training.

Destination Planners is an award-winning travel agency that helps clients book vacations and travel experiences. The company provides tools and mentorship, fostering an environment for individuals to build their own travel business with flexible schedules and travel perks.

North America

  • Respond to guest inquiries using templates and property information.
  • Monitor cleaning schedules daily and weekly and confirm cleaners arrive on time.
  • Process guest resolution claims and coordinate with maintenance and vendors.

They are looking for a highly reliable, detail-oriented, and proactive Guest Support Specialist to help manage daily operations across our short-term rental properties. This role is ideal for someone who takes ownership of their work, communicates clearly, and thrives in a structured, fast-paced environment.

$57,000–$71,200/yr
US

  • Write exciting, sharp, and persuasive copy for emails, websites, and marketing materials.
  • Manage deadlines, edit colleagues' work, and execute revenue-driving email and text campaigns.
  • Research and learn obsessively about consumer psychology, the pet industry, and copywriting techniques.

The company creates products for pets to help them live longer, healthier lives. It has a revenue-focused, collaborative culture and offers employee stock ownership and charitable giving programs.

US

  • Interpret a variety of imaging studies including X-ray, CT, MRI, and Ultrasound
  • Deliver accurate and timely diagnostic reports
  • Maintain high standards of quality and efficiency in a remote setting

Imagen Technologies is a leading physician-led, AI-enabled radiology practice. Their mission is to ensure every patient receives the right diagnosis at the right time via advanced technology and a collaborative clinical culture, empowering radiologists to practice efficiently while maintaining flexibility and work-life balance.

US

  • Conduct virtual physical therapy evaluations and follow‑up visits via secure telehealth platforms
  • Develop and implement individualized treatment plans appropriate for virtual delivery
  • Educate patients on injury prevention, home exercise programs, posture, ergonomics, and self‑management

TeleMed2U increases access to care across 20 medical and behavioral health specialties nationwide. They are a leading technology-enabled healthcare services company, delivering high-quality, convenient, and easy-to-access virtual healthcare solutions.

Global

  • Edit and post short-form videos using CapCut or Canva.
  • Respond to all inbound messages and qualify leads.
  • Enter leads into JobTread, update pipeline stages, and schedule consultations.

20four7VA connects offshore independent contractors with clients worldwide, focusing on developed markets. They aim to improve business efficiency for clients through high-quality, task-specific services provided by qualified contractors.

$45,000–$65,000/yr
US

  • Process and confirm hotel bookings through preferred travel partners while communicating with clients regarding rates and availability.
  • Provide professional customer service via phone, email, or chat to assist guests with reservations and itinerary coordination.
  • Research properties and destination amenities to match client needs, maintaining accurate records of reservations and preferences.

Destination Knot operates in the travel and hospitality industry, focusing on travel planning and coordination services. The company values service, growth, and professionalism, offering a remote team structure with opportunities for professional development and advancement.

$232,500–$325,500/yr
US

  • Lead and mentor a high-performing team of data scientists focused on the Marketing & Business Development domain.
  • Communicate and shape the roadmap and strategy for Reddit by identifying actionable and impactful insights.
  • Lead initiatives to quantify the true incremental lift of marketing spend and prevent budget allocation on non-incremental channels.

Reddit is a community of communities built on shared interests, passion, and trust. It is home to open and authentic conversations, with 100,000+ active communities and approximately 121 million daily active unique visitors.

$120,000–$130,000/yr
US

  • Own the end-to-end identification and execution of a full-funnel keyword strategy.
  • Actively monitor keyword performance and implement on-page optimization tactics to secure "Position 1" rankings.
  • Develop and execute strategies to ensure brand authority within AI-generated answers and LLMs and conversational search platforms.

KnowBe4 is the global leader in Human Risk Management, trusted by over 70,000 organizations worldwide to secure their employees and AI agents. They're pioneering a new era of security, AI-powered since 2016 and market-leading since day one.

$119,000–$149,000/yr
US

  • Architect and develop full-stack applications that align with EDC’s AI & Digital Transformation strategy and drive high-priority business outcomes.
  • Implement modular “Lego-block” architectures that are reusable and interoperable across business development, programmatic, and core business systems through API-first, cloud-native solutions.
  • Integrate responsible AI by leveraging AWS Bedrock, CrewAI, and other AI services to design and deploy agentic AI teams and intelligent solutions.

Education Development Center (EDC) is a global nonprofit that works with partners to advance every person’s journey to learn, work, and be well. Founded in 1958, EDC today brings together a global team working across the United States and around the world.

$60,000–$90,000/yr
Global

  • Guiding families through tailored benefit options
  • Running virtual consultations with confidence
  • Building long-term trust-based relationships

I am sorry, I cannot extract the company description because it is not provided in the job posting. The job posting implies that they offer meaningful work.

US

  • Execute for campaigns across Google Ads, Microsoft Ads, and paid social channels.
  • Optimize campaigns for conversion rate, CPA, and ROAS.
  • Partner with internal teams to align paid media with broader strategy.

Compose.ly is a search and content marketing agency helping brands grow through data-driven insights and high-quality content. As they expand their paid media capabilities, they’re building a network of experienced contractors who can step in to support client work as needed.

US

  • Conduct video consultations and communicate with patients via telemedicine.
  • Assess, diagnose, and treat patients, including prescribing medication when clinically appropriate.
  • Provide supervision and oversight to Nurse Practitioners (NPs) in states requiring collaborative agreements.

UpLift & BetterHelp is redefining access to mental healthcare by applying technology to empower patients to find Therapists and Psychiatric providers covered by their insurance plan. UpLift acts as the bridge between patient, provider, and insurer to help patients find the best care at a price they can afford.

US

  • Drive growth through data-driven initiatives that generate patient starts from employer partners.
  • Lead the end-to-end execution of activation campaigns, optimizing touchpoints for conversion through A/B testing.
  • Automate workflows with AI and MarTech tools and develop scalable playbooks to serve as a force multiplier.

Rula is committed to treating the whole person and aims to create a world where mental health is embraced as an integral part of overall well-being. They provide quality care and empower individuals to take charge of their mental health and achieve their full potential.

US

  • Assist developers and power companies in executing significant solar projects.
  • Oversee project aspects from initiation to completion, ensuring successful delivery.
  • Lead the on-site Quality Management process and ensure safety program implementation.

Columbia General focuses on renewable energy projects. They foster a collaborative environment and are dedicated to sustainability and energy solutions.

US

  • Rapid Estimation: Create Rough Order of Magnitude (ROM) estimates within 24 hours using historical data, even when drawings are incomplete.
  • Procurement & Negotiation: Call US vendors, verifying quotes, and negotiating deals to protect our budget.
  • Scoping & Logic: Identify scope gaps, including framing, drywall, paint, and trim.

Stony Creek Homes is a fast-paced "Fix & Flip" real estate company in the DC/Maryland/Virginia market. They buy distressed homes, renovate them, and sell them for a profit.