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Remote Appeals & Grievance Specialist

Remote / Online - Candidates ideally in
Austin, Travis County, Texas, 78716, USA
Listing for: RiseMe
Full Time, Remote/Work from Home position
Listed on 2026-09-27
Job specializations:
  • Healthcare
    Healthcare Administration
Salary/Wage Range or Industry Benchmark: 49000 - 71000 USD Yearly USD 49000.00 71000.00 YEAR
Job Description & How to Apply Below

Well Sense Health Plan is seeking an Appeals and Grievance Specialist for full-time remote work. The role handles medical and pharmacy member appeals and complaints, ensuring regulatory and contractual compliance across CMS, Mass Health, and DHHS directives.

The position requires 2+ years in managed care, Medicare/PH prior authorizations, and NCQA standards familiarity, with strong communication and problem-solving abilities. Competitive salary and comprehensive benefits offered.

We have an opening for a Remote Appeals & Grievance Specialist in United States within Bio & Pharmacology & Health.

This role, Remote Appeals & Grievance Specialist at Rise Me, could be your next opportunity.

Are you ready to take on the Remote Appeals & Grievance Specialist role at Rise Me?

We would love to welcome a new Remote Appeals & Grievance Specialist to our group in United States.

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