(REMOTE) Appeals and Grievance Representative (GA, Powder Springs)
Locations: Alabama, Florida, Georgia, Illinois, Kentucky, Maryland, North Carolina, South Carolina, Tennessee, Texas, Virginia, and Washington State
Position Type: Full-Time | Remote
Pay Rate: $17.75/hour base pay plus an additional $5.36/hour applied toward health and welfare benefits or retirement (depending on benefit election).If health benefits are not needed (candidate has TRICARE, VA, or spouse provided health coverage) the $5.36 per hour is placed in a 401(a)-tax deferred account where 3% of the funds are matched by the company. If the candidate needs health, vision, dental insurance from the company, the $5.36 per hour pay is applied to cover health benefit options selected.
Position Summary:
Widescope Consulting and Contracting is urgently hiring experienced Appeals and Grieveance Representatives to support a remote healthcare initiative. In this role, you will be responsible for reviewing, researching, and resolving member and provider appeals and grievances with accuracy and professionalism. We are seeking candidates who can start right away and bring strong claims experience, problem-solving skills, and attention to detail.
Key Responsibilities:
Review and resolve appeal and grievance cases
Research underlying issues and apply appropriate policy guidelines (CMS, TRICARE)
Communicate decisions clearly with internal teams and external parties
Maintain organized, accurate documentation for each case
Work independently in a fast-paced, non-scripted environment
Required Qualifications:
High School Diploma / GED (or higher)
2+ years of healthcare claims benefits experience (including denial research)
1+ year of customer service experience
1+ year of claims appeal experience
Proficiency in Microsoft Word and Excel
Preferred Skills:
Familiarity with TRICARE or Medicare (CMS) policies and procedures
Strong time managment and analytical thinking
Excellent verbal and written communication skills
Remote Work Requirements:
A quiet, dedicated home workspace free of distractions
Reliable high-speed internet (minimum 50Mbps down / 7 Mbps up)
Wired internet connection (LAN) preferred
Ability to perform basic troubleshooting with phone support from tech team
Company-provided equipment (computer, monitors, webcam, headset, cables) and support.
Apply now! We are hiring immediately and reviewing qualified candidates on a rolling basis.
Apply Now
Position Type: Full-Time | Remote
Pay Rate: $17.75/hour base pay plus an additional $5.36/hour applied toward health and welfare benefits or retirement (depending on benefit election).If health benefits are not needed (candidate has TRICARE, VA, or spouse provided health coverage) the $5.36 per hour is placed in a 401(a)-tax deferred account where 3% of the funds are matched by the company. If the candidate needs health, vision, dental insurance from the company, the $5.36 per hour pay is applied to cover health benefit options selected.
Position Summary:
Widescope Consulting and Contracting is urgently hiring experienced Appeals and Grieveance Representatives to support a remote healthcare initiative. In this role, you will be responsible for reviewing, researching, and resolving member and provider appeals and grievances with accuracy and professionalism. We are seeking candidates who can start right away and bring strong claims experience, problem-solving skills, and attention to detail.
Key Responsibilities:
Review and resolve appeal and grievance cases
Research underlying issues and apply appropriate policy guidelines (CMS, TRICARE)
Communicate decisions clearly with internal teams and external parties
Maintain organized, accurate documentation for each case
Work independently in a fast-paced, non-scripted environment
Required Qualifications:
High School Diploma / GED (or higher)
2+ years of healthcare claims benefits experience (including denial research)
1+ year of customer service experience
1+ year of claims appeal experience
Proficiency in Microsoft Word and Excel
Preferred Skills:
Familiarity with TRICARE or Medicare (CMS) policies and procedures
Strong time managment and analytical thinking
Excellent verbal and written communication skills
Remote Work Requirements:
A quiet, dedicated home workspace free of distractions
Reliable high-speed internet (minimum 50Mbps down / 7 Mbps up)
Wired internet connection (LAN) preferred
Ability to perform basic troubleshooting with phone support from tech team
Company-provided equipment (computer, monitors, webcam, headset, cables) and support.
Apply now! We are hiring immediately and reviewing qualified candidates on a rolling basis.
Apply Now