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benefits investigation specialist / remote Jobs in New York

healthcare appeals specialist - remote Jobs in New York

healthcare appeals specialist - remote

investment banking associate - healthcare m&a Jobs in New York

medical assistant ii-selikoff centers for occupational health Jobs in New York

offsite medical office specialist-msw-ft days Jobs in New York

healthcare appeals specialist remote

4 Corner Resources

<div>
 
 Healthcare Appeals Specialist (Remote - 4 Month Contract)
 
 
 Pay:
 
 $21-$25/hr
 
 
 Schedule:
 
 Must work
 
 East Coast business hours
 
 
 
 Duration:
 
 
 4-month contract
 
 
 Job Overview
 
 We are seeking a
 
 Healthcare Appeals Specialist
 
 to support the intake, review, and preparation of healthcare appeals and Independent Dispute Resolution (IDR) cases. This role ensures cases are processed accurately, documented properly, and completed within regulatory timelines.
 
 Responsibilities
 <ul>
 <li>
 Manage intake and tracking of
 
 appeals and IDR cases
 
 </li>
 <li>
 Review case documentation for
 
 accuracy and compliance
 
 </li>
 <li>
 Prepare
 
 appeal packets, summaries, and supporting documentation
 
 </li>
 <li>
 Monitor cases to ensure
 
 regulatory deadlines are met
 
 </li>
 <li>
 Maintain accurate records in case management systems
 </li>
 <li>
 Collaborate with internal teams to resolve cases
 </li>
 </ul>
 Qualifications
 <ul>
 <li>
 Minimum of a High School Diploma or GED required.&nbsp;
 </li>
 <li>
 
 1-3 years of healthcare experience
 
 (appeals, claims, managed care, or healthcare operations)
 </li>
 <li>
 Strong attention to detail and ability to manage multiple cases
 </li>
 <li>
 This is a remote position; however, candidates must reside in one of the following states where the company is currently registered to employ staff:
 </li>
 <li>
 
 AL, FL, GA, IN, IA, KS, MS, NC, NE, NV, NH, NJ, NY, OK, SC, SD, TN, TX, VA, WV, or WY.
 
 </li>
 </ul>
 Preferred
 <ul>
 <li>
 
 Experience with
 
 OnBase, TruCare, Hyland, or SharePoint
 
 
 
 
 
 &nbsp;
 
 
 </li>
 </ul>
</div>

Healthcare Appeals Specialist - Remote

MedRite Urgent Care

Remote Patient Monitoring (RPM) Specialist+MEDRITE Chronic Care Management ProgramLocation: Onsite &ndash; 40 Fulton Street, New York, NY 10038Pay: $25.00 &ndash; $30.00 per hour Department: Chronic Care Management (CCM)About +MEDRITE+MEDRITE is a leading healthcare organization committed to delivering accessible, patient-centered care through innovative care programs and technology. Our Chronic Care Management (CCM) program supports patients living with chronic conditions through proactive monitoring, care coordination, and patient engagement.We are seeking a Remote Patient Monitoring (RPM) Specialist to support our growing population health programs and help improve patient outcomes through data-driven monitoring and patient outreach.Position OverviewThe Remote Patient Monitoring (RPM) Specialist monitors patient health data transmitted from remote devices and communicates with patients to support adherence to care plans and monitoring protocols. This role works closely with Care Managers, clinical staff, and providers to identify concerning readings, escalate clinical issues, and ensure accurate documentation for CCM and RPM services.This is an onsite position based at our corporate office in Manhattan.Key ResponsibilitiesPatient Monitoring<ul><li>Monitor patient health data transmitted from remote monitoring devices including:</li><li>Blood pressure monitors</li><li>Glucose monitors</li><li>Pulse oximeters</li><li>Weight scales</li><li>Identify readings outside clinical parameters and escalate concerns according to established protocols.</li></ul>Patient Engagement<ul><li>Conduct outbound calls to patients to review readings, encourage compliance, and reinforce care plans.</li><li>Provide education on device usage and monitoring expectations.</li><li>Follow up with patients who miss scheduled monitoring or fail to transmit readings.</li></ul>Care Coordination<ul><li>Collaborate with Care Managers, Nurses, and Providers to support patient care plans.</li><li>Escalate abnormal readings or concerning symptoms to clinical leadership.</li></ul>Documentation &amp; Compliance<ul><li>Document all patient interactions in the Electronic Health Record (EHR) or RPM platform.</li><li>Maintain accurate records in compliance with CMS Remote Patient Monitoring and Chronic Care Management billing requirements.</li><li>Ensure all activities meet HIPAA and healthcare compliance standards.</li></ul>Productivity ExpectationsRPM Specialists play a key role in supporting the operational and compliance requirements of the CCM program.Expectations include:<ul><li>Maintain consistent engagement with assigned RPM patient panel.</li><li>Achieve a minimum average of 20 minutes of documented patient interaction per enrolled RPM patient per calendar month, consistent with CMS RPM guidelines.</li><li>Complete documentation same day or within 24 hours of patient interaction.</li><li>Conduct timely follow-up with patients who miss readings or demonstrate abnormal results.</li><li>Maintain high standards of documentation accuracy, patient engagement, and care coordination.</li></ul>QualificationsEducation<ul><li>Associate&rsquo;s or Bachelor&rsquo;s degree in Healthcare Administration, Public Health, Nursing, or related field preferred</li></ul>Experience<ul><li>1&ndash;3 years healthcare experience preferred</li><li>Experience with Remote Patient Monitoring (RPM), Chronic Care Management (CCM), population health, or care coordination strongly preferred</li><li>Experience using Electronic Health Records (EHR)</li></ul>Skills<ul><li>Strong patient communication skills</li><li>Ability to recognize abnormal health readings</li><li>Excellent documentation and organizational skills</li><li>Comfortable working with healthcare technology and remote monitoring platforms</li><li>Ability to manage multiple patients and workflows simultaneously</li></ul>Work Environment<ul><li>Onsite role</li><li>Corporate office location:</li><li>40 Fulton Street, New York, NY 10038</li><li>Office-based position with frequent patient communication via phone and electronic systems</li><li>Collaborative team environment supporting chronic disease management.</li><li>$25.00 &ndash; $30.00 per hour</li><li>Opportunity to work in a growing population health program</li><li>Professional development opportunities</li><li>Collaborative healthcare environment.</li></ul>Equal Employment Opportunity+MEDRITE is an Equal Opportunity Employer and complies with all applicable federal, New York State, and New York City employment laws. We prohibit discrimination based on race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, pregnancy, marital status, military status, veteran status, genetic information, or any other protected characteristic under applicable law.+MEDRITE provides reasonable accommodations to qualified individuals with disabilities and to employees with sincerely held religious beliefs, in accordance with applicable laws.Apply today to join +MEDRITE and help improve patient outcomes through innovative chronic care management and remote patient monitoring programs.Pay: $25.00 - $30.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Remote Patient Monitoing Specialist

The PromptCare Companies, Inc.

<div>Description:

PromptCare is looking for a Clinical Compliance Coordinator to support clinical review and regulatory compliance within the Intake &amp; Resupply department. This full-time hybrid role is responsible for evaluating medical documentation to determine eligibility, coverage, and medical necessity in accordance with Medicare, CMS guidelines, and payer policies. The ideal candidate will have experience in Medicare Advantage or managed care, strong knowledge of Medicare regulations, and the ability to interpret medical records, identify documentation gaps, and support appeals while ensuring full compliance.
Job Type: Full time/ Hybrid
Job Location: hybrid 2 days per week in King of Prussia, PA
Requirements:
<ul><li>The Clinical Compliance Coordinator is responsible for evaluating clinical information to determine member eligibility, coverage, and medical necessity in accordance with Medicare regulations, CMS guidelines, and organizational policies.</li><li>
This role ensures compliance with federal requirements while supporting high-quality, cost-effective patient care.</li><li>
Provide feedback and guidance for a written appeals process to overturn authorization denials.</li><li>
Effectively identify missing or non-complaint documentation required under CMS guidelines and published medical policies for governmental and commercial payers.</li></ul>
Qualifications:<ul><li>
Prior experience in Medicare Advantage or managed care organizations</li><li>
Certification in Case Management (CCM), Utilization Review (CPUR), or equivalent</li><li>
 Experience with audits, appeals, and regulatory compliance</li><li>
Administrative focus with Clinical background</li><li>
Minimum 2&ndash;5 years of experience (acute care, managed care, or Medicare populations preferred)</li><li>
Strong knowledge of Medicare Parts A, B, C, and/or D</li><li>
Experience with utilization management, case management, or clinical review</li><li>
Familiarity with CMS regulations, medical necessity criteria, and evidence-based guidelines (InterQual, MCG, or similar)</li><li>
Strong analytical, documentation, and communication skills</li><li>
Proficiency with electronic medical records and clinical review systems</li><li>
Ability to interpret medical records, particularly chart notes including test results, diagnosis, medical verbiage pertaining to CMS guidelines</li><li>
Must be able to interpret and comprehend published payer medical policies</li><li>
Determine Contraindicators within published medical policies for acceptance while maintaining compliance practices</li></ul>
Benefits &amp; Perks<ul><li>
Comprehensive Medical, Dental, and Vision Package</li><li>
401(k) Plan with Company Match</li><li>
Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays</li><li>
Life Insurance: Standard coverage with optional enhancements</li><li>
Employee Assistance Program: Free counseling and coaching sessions</li><li>
Emotional Well-being and Work-Life Balance Resources</li><li>
Short &amp; Long-Term Disability: Company-paid with optional supplements</li><li>
Accidental Death and Dismemberment Insurance</li><li>
FSA and HSA: Manage healthcare expenses</li><li>
Commuter Spending Programs</li><li>
Volunteer and Engagement Opportunities</li><li>
Employee Referral Bonuses</li><li>
Exclusive Discounts on entertainment, travel, and various other supplemental and cellphone plans</li></ul>
Equal Employment Opportunity
The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.</div>

Clinical Compliance Coordinator

CVS Health

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
Position Summary 
Responsible for managing to resolution complaint/appeal scenarios for all products, which may contain multiple issues and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to complaints/appeals. Identify trends and emerging issues and report and recommend solutions. 
 
Required Qualifications<ul><li>
1 plus years knowledge of plan documents, claims research, letter writing.</li><li>
1 plus years working with appeals, claims, or compliance. (and/ or)</li><li>
1 plus years experience working with documenting and interpreting Health Insurance plans.</li><li>
Understand excel and word.</li><li>
Able to interpret benefits.</li><li>
Healthcare experience.</li></ul> 
Preferred Qualifications<ul><li>
3 plus years of prior claim or health insurance experience.</li><li>
Familiarity with medical terminology, self funding or ERISA requirements.</li></ul> 
Education<ul><li>
Associate Degree or High School Diploma/GED and equivalent experience.</li></ul>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$18.50 - $42.35
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 03/06/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Senior Appeals Examiner

JAK Travel Agency

<div>
 We are seeking a Remote Customer Support Specialist to provide exceptional assistance to travelers from a home-based setting, serving customers in New York, NY and across the United States.
 
 
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Respond to customer inquiries via email, chat, and phone in a timely and professional manner.
 </li>
 <li>
 Troubleshoot and resolve customer issues efficiently.
 </li>
 <li>
 Maintain accurate records of customer interactions.
 </li>
 <li>
 Collaborate with team members to improve service processes.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Strong written and verbal communication skills.
 </li>
 <li>
 Customer-focused attitude and effective problem-solving abilities.
 </li>
 <li>
 Comfortable with remote work and familiar with common technology and support tools.
 </li>
 <li>
 Previous customer service or travel-industry experience is a plus.
 
 
 </li>
 </ul>
 
 Benefits
 
 
 
 <ul>
 <li>
 Fully remote role.
 </li>
 <li>
 Flexible schedule.
 </li>
 <li>
 Travel-related perks and incentives.
 </li>
 <li>
 Opportunities for growth and professional development.
 </li>
 </ul>
</div>

Remote Travel Advisor Support – Flexible & Fully Remote

Work From Home Co.

<div>
 This is a remote position.
 
 
 We are seeking a motivated and detail-oriented
 
 Remote Guest Experience Specialist
 
 to join our remote team. In this role, you will assist customers with inquiries, scheduling, account updates, and service coordination while delivering a high level of professionalism and care. This position is ideal for someone who enjoys helping people, solving problems, and working in a fast-paced remote environment. You will serve as a key point of contact for customers, ensuring a smooth and positive experience from initial request through follow-up support.
 
 
 
 Requirements
 
 
 
 <ul>
 <li>
 Previous experience in customer service, hospitality, call center, or administrative roles preferred
 </li>
 <li>
 Strong written and verbal communication skills
 </li>
 <li>
 Comfortable working independently in a remote environment
 </li>
 <li>
 Basic computer skills and ability to learn new systems quickly
 </li>
 <li>
 Reliable internet connection and a distraction-free workspace
 </li>
 <li>
 Strong attention to detail and organizational skills
 </li>
 <li>
 Positive attitude and solution-focused mindset
 
 
 </li>
 </ul>
 Key Responsibilities
 
 
 <ul>
 <li>
 Respond to customer inquiries via email, chat, and phone in a timely and professional manner
 </li>
 <li>
 Assist with service requests, scheduling updates, and general account support
 </li>
 <li>
 Provide clear information about available services and options
 </li>
 <li>
 Maintain accurate records using internal systems and CRM tools
 </li>
 <li>
 Resolve basic customer concerns and escalate complex issues when necessary
 </li>
 <li>
 Follow internal processes to ensure quality and consistency
 </li>
 <li>
 Support team initiatives and ongoing customer experience improvements
 
 
 </li>
 </ul>
 
 Benefits
 
 
 
 Benefits
 
 
 <ul>
 <li>
 Remote work flexibility
 </li>
 <li>
 Competitive pay with performance-based opportunities
 </li>
 <li>
 Flexible scheduling options
 </li>
 <li>
 Ongoing training and professional development
 </li>
 <li>
 Supportive and collaborative team environment
 </li>
 <li>
 Advancement opportunities based on performance
 
 
 </li>
 </ul>
 
 Equal Opportunity
 
 
 
 We celebrate diversity and are committed to creating an inclusive environment for all team members. All qualified applicants will be considered without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, or disability.
 
 
</div>

Remote Guest Experience Specialist

Careers In Travel | Destination Planners

<div>
 
 Job Overview
 
 
 
 Destination Knot is seeking a detail-oriented
 
 Remote Reservation Support Specialist
 
 to assist with client reservation requests and provide administrative support related to booking and scheduling services. This is a remote support role focused on customer service, coordination, and accurate data handling within a reservations environment.
 
 
 This position is ideal for individuals who are organized, professional, and comfortable working independently in a remote setting.
 
 
 
 Key Responsibilities
 
 
 
 Assist with reservation and scheduling requests submitted by clients
 
 
 Support booking coordination across various service categories, including accommodations and related services
 
 
 Maintain accurate client records and reservation details in internal systems
 
 
 Communicate professionally with clients via email, phone, or messaging platforms
 
 
 Provide general customer service support and follow established processes
 
 
 Review confirmations and documentation for accuracy and completeness
 
 
 Collaborate with internal teams to ensure a smooth client experience
 
 
 
 Qualifications
 
 
 
 Strong written and verbal communication skills
 
 
 Excellent attention to detail and organizational abilities
 
 
 Comfortable using online systems, email, and basic digital tools
 
 
 Ability to manage multiple tasks while meeting deadlines
 
 
 
 Customer Service Or Administrative Support Experience Preferred
 
 
 
 Reliable internet access and ability to work remotely
 
 
 
 Work Environment
 
 
 
 Fully remote position
 
 
 Flexible scheduling options may be available
 
 
 Supportive, structured team environment
 
 
 We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
</div>

Remote Reservation Support Specialist

Explore 495+ Healthcare appeals specialist remote in New York this March. Find roles across top companies and apply now to boost your career.