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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 100% Full Time. Highlights an 100% Remote job distribution.

Appeals Manager - Fully Remote | Upto $93/hr

San Francisco, CA • Remote

Mercor
See more jobs at Mercorexternal

$93/hr

Full-time

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

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Denials Management & Appeals Manager
Type: Contract
Compensation: $93/hour
Location: Remote

Role Responsibilities

  • Lead denials management and appeals operations. Oversee the identification, categorization, and resolution of claim denials.
  • Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness.
  • Analyze denial trends by payer, denial code (CARC/RARC), and denial category to identify systemic root causes.
  • Develop and manage clinical and technical appeal strategies across multiple payer types.
  • Coordinate with clinical, coding, billing, and compliance teams to implement denial prevention initiatives.
  • Monitor denial management KPIs including denial rates, appeal overturn rates, revenue recovery, and days in A/R.
  • Ensure compliance with payer appeal requirements, CMS regulations, and timely filing deadlines.
  • Annotate AI outputs and provide structured feedback to support AI training datasets.

Qualifications

Must-Have

  • 5+ years of experience in denials management, appeals, or revenue cycle operations, with at least 2 years in a management role.
  • Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across commercial, Medicare, and Medicaid payers.
  • Strong understanding of clinical and technical appeal processes including peer-to-peer reviews and external reviews.
  • Experience with denial analytics platforms and revenue cycle reporting tools.
  • Proficiency with EHR systems and billing platforms.
  • Exceptional written and verbal English communication skills.
  • High attention to detail with the ability to evaluate appeal quality and identify errors in AI-generated denial management content.

Preferred

  • CPC, CCS, CRCR, or CHFP certification.
  • Experience with AI-assisted denial management platforms (e.g., Waystar, Experian Health, Nthrive).
  • Background in complex clinical appeals including medical necessity, experimental/investigational, and level of care denials.
  • Familiarity with AI tools and comfort evaluating AI-generated appeal and denial content.
  • Experience presenting denial management performance to revenue cycle leadership.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.