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Remote Appeals Jobs in California (NOW HIRING)

LIBERTY DENTAL

$23 - $28.50/hr

Make a Meaningful Impact as a Manager, Grievance & Appeals. At Liberty Dental Plan, the Manager ... Remote or hybrid work options available for various positions. Compensation In the spirit of pay ...

MedImpact

Appeals & Grievances Coordinator II

San Diego, CA · On-site +1

$25.50 - $31.19/hr

The Appeals & Grievances Coordinator II serves as a key member of the A&G team, processing appeal ... remote location with management approval based on business requirements). Must provide adequate ...

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Remote Appeals information

What is a remote appeals?

A Remote Appeals job involves reviewing and processing appeals related to denied claims, decisions, or disputes, typically in industries like healthcare, insurance, or financial services. Professionals in this role analyze appeal cases, gather necessary documentation, and communicate with relevant parties to ensure fair resolutions. They often work remotely, using digital tools to assess appeals, follow regulations, and meet deadlines. Strong attention to detail, knowledge of industry policies, and communication skills are essential for success in this role.

What are the key skills and qualifications needed to thrive in the remote appeals position?

To thrive as a Remote Appeals professional, you need expertise in reviewing and processing appeals, a solid understanding of compliance or regulatory guidelines, and relevant industry experience, often in insurance, healthcare, or legal fields. Familiarity with case management software, document management systems, and standard office tools like Microsoft Office or Google Workspace is essential. Strong analytical abilities, attention to detail, effective written communication, and problem-solving skills help you stand out in this position. These capabilities ensure accurate, efficient appeal resolution and positive experiences for clients or claimants in a remote work environment.

What are typical challenges faced by remote appeals professionals, and how do teams address them?

Remote Appeals professionals often navigate complex regulations, tight deadlines, and high volumes of cases, which can be challenging without direct, in-person team support. Teams typically address these by using structured workflows, regular video meetings, and clear communication channels to ensure consistency and collaboration. Many employers provide comprehensive training and accessible digital resources to help remote staff stay updated on policies and best practices. By fostering a supportive virtual environment, organizations help Remote Appeals specialists efficiently manage their caseloads and maintain high-quality work standards.

What are the most commonly searched types of Appeals jobs in California?

The most popular types of Appeals jobs in California are:

What are popular job titles related to Remote Appeals jobs in California?

For Remote Appeals jobs in California, the most frequently searched job titles are:

What job categories do people searching Remote Appeals jobs in California look for?

The top searched job categories for Remote Appeals jobs in California are:

What cities in California are hiring for Remote Appeals jobs?

Cities in California with the most Remote Appeals job openings:

Remote Appeals jobs near you
Infographic showing various Remote Appeals job openings in California as of August 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 80% Physical, 6% Hybrid, and 14% Remote job distribution.

Grievance & Appeals Manager

LIBERTY DENTAL

On-site, Remote

$23 - $28.50/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Lead with Purpose. Drive Quality. Make a Meaningful Impact as a Manager, Grievance & Appeals.
At Liberty Dental Plan, the Manager, Grievance & Appeals plays a vital leadership role in ensuring members and providers receive fair, timely, and compliant resolution of concerns and disputes. This is an opportunity to influence quality, compliance, operational excellence, and regulatory readiness across multiple lines of business while leading a high-performing team and collaborating with stakeholders across the organization.
About the Role
The Manager, Grievance & Appeals is responsible for overseeing the Plan's grievance system, including member grievances, appeals, and provider disputes. This leader ensures all cases are managed in accordance with state and federal regulations, client requirements, and organizational standards. The role serves as a subject matter expert responsible for supporting regulatory compliance, quality outcomes, policy governance audit readiness and continuous improvement initiatives.
What You'll Do
  • Lead and manage all activities and functions of the Grievance & Appeals department.
  • Ensure grievances, appeals, and provider disputes are processed accurately and within required regulatory and contractual timelines.
  • Monitor and interpret federal, state, client and regulatory changes impacting grievance and appeals operations.
  • Lead root cause analysis activities, develop corrective action strategiesstrategies, and partner with business leaders to address issues and drive improvements.
  • Evaluate workflows and delegated activities for existing health plan partnerships and support implementation of processes for new partnerships.
  • Develop and present performance reports, trend analyses, and regulatory insights to leadership teams, clients, auditors and regulatory agencies.
  • Manage administrative and operational support for Quality Management committees, including the Potential Quality Issues Committee, Peer Review Committee, and Public Policy Committee.
  • Assist with regulatory filings, including Evidence of Coverage documents, benefit updates, service area expansions, and other plan-related submissions.
  • Respond to regulatory inquiries, comment letters, and compliance-related requests.
  • Create and validate audit universes, case files, and supporting documentation.
  • Serve as Liberty Dental Plan's primary presenter and representative during internal and external Grievance & Appeals audits.
  • Foster positive, professional relationships with internal and external stakeholders.
  • Perform additional duties as assigned.
What You'll Bring
Education & Experience
  • Bachelor's degree preferred.
  • Minimum 5 years of experience in health insurance, preferably within dental insurance.
  • Minimum 3 years of experience in grievance and appeals, healthcare law, dental law, or a related regulatory environment.
  • Minimum 2 years of leadership experience managing cross-functional operations, including hiring, training, coaching, and performance management.
  • At least 6 years of overall relevant professional experience.
Skills & Knowledge
  • Strong collaborative leadership style.
  • Excellent verbal and written communication skills.
  • Effective presentation and facilitation abilities.
  • Proficiency with Microsoft Office applications.
  • Ability to analyze complex situations and make sound business decisions.
  • Strong organizational skills with the ability to manage multiple priorities simultaneously.
  • Demonstrated ability to work independently while contributing as a key member of a team.
  • Professional presence with the ability to build confidence and trust across stakeholder groups.
Why Join Liberty Dental Plan?
This is an opportunity to lead an essential function that directly impacts member experience, regulatory compliance, quality outcomes, and organizational success. You'll work across departments, influence strategic initiatives, support executive leadership, and play a visible role in audit readiness and quality management activities.
If you're a collaborative leader who thrives in a dynamic healthcare environment and enjoys solving complex operational and regulatory challenges, we'd love to hear from you.
Apply Today
Bring your expertise in grievance and appeals operations, compliance, and team leadership to Liberty Dental Plan and help drive excellence in service, quality, and regulatory performance. Apply today and become part of a team committed to delivering exceptional support to members, providers, and clients.
Location
Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.
What Liberty Offers
Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That's why Liberty offers competitive and attractive benefit packages for our employees. We strive to care for employees in ways that promote wellness and productivity.
Our first-class benefits package supports employees and their dependents with:
  • Competitive pay structure and savings options to help you reach your financial goals.
  • Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines.
  • Affordable medical insurance, with low-cost premiums for employee-only coverage. Liberty subsidizes the cost for eligible dependents enrolled in the plan.
  • 100% employer-paid dental coverage for employees and eligible dependents.
  • Vision insurance with low-cost premiums for employee-only coverage and dependents.
  • Company-paid basic life and AD&D insurance, equal to one times your base salary, with options to purchase additional supplemental coverage.
  • Flexible Spending Accounts for healthcare and dependent care expenses.
  • Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance.
  • Long-term disability coverage.
  • Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts.
  • Employee Assistance Program (EAP) to support mental health and well-being.
  • Generous vacation and sick leave policies, with the ability to roll over unused time.
  • 10 paid company holidays.
  • Tuition reimbursement for eligible educational expenses.
  • Remote or hybrid work options available for various positions.

Compensation
In the spirit of pay transparency, the base salary range for this position is $85,000 - $95,000, not including fringe benefits or potential bonuses. At Liberty, your final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider the internal equity of our current team members when making final compensation decisions.
Please note that the range listed represents the full base salary range for this role. Typically, offers are not made at the top of the range to allow for future salary growth.
Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture.
Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve.
We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.
Sponsorship and Relocation Specifications
Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.
No relocation assistance or sponsorship available at this time.

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