Remote Appeals & Grievances Clinical Specialist III
Remote / Online - Candidates ideally in
Columbus, Franklin County, Ohio, 43224, USA
Listed on 2026-08-10
Columbus, Franklin County, Ohio, 43224, USA
Listing for:
Remote Jobs
Remote/Work from Home
position Listed on 2026-08-10
Job specializations:
-
Healthcare
Healthcare Management, Healthcare Administration, Healthcare Compliance
Job Description & How to Apply Below
Medica is seeking an Appeals and Grievances Clinical Specialist III to lead clinical reviews of member and provider appeals across pre-service, concurrent, and post-service cases. The role ensures regulatory compliance and supports STARs performance through evidence-based decision making.
This remote position requires an active RN license and 5+ years of clinical experience. Salary ranges from $70,200 to $120,400 annually, with a typical hiring range of $70,200 - $105,315, plus comprehensive
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