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Remote Appeals Jobs in Ohio (NOW HIRING)

Manulife

Senior Underwriting Consultant

Delaware, OH · On-site +1

$93K - $110K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... Process formal underwriting appeals and complaints. * Review underwriting fraud referrals for ...

Manulife

Senior Underwriting Consultant

New Hampshire, OH · On-site +1

$88K - $104K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... Process formal underwriting appeals and complaints. * Review underwriting fraud referrals for ...

Stotler Hayes Group

Paralegal

Mason, OH · On-site +1

Maintain proactive follow-up on appeals, pleadings, verifications, and agency requests * Manage ... Comfort collaborating with remote team members using video conferencing, messaging, and cloud-based ...

Valeris

Executive Case Manager (Remote)

Cincinnati, OH · Remote

This includes completing benefit investigations, tracking prior authorizations / denial appeals ... Remote work eligibility is subject to all work from home criteria met and based on business need ...

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Remote Appeals information

See Ohio salary details

$29K

$82.2K

$109.8K

How much do remote appeals jobs pay per year?

As of Aug 26, 2026, the average yearly pay for remote appeals in Ohio is $82,217.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,200.00 and $93,600.00 per year, depending on experience, location, and employer.

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 Ohio?

The most popular types of Appeals jobs in Ohio are:

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

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

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

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

What cities in Ohio are hiring for Remote Appeals jobs?

Cities in Ohio with the most Remote Appeals job openings:

Remote Appeals jobs near you
Infographic showing various Remote Appeals job openings in Ohio as of August 2026, with employment types broken down into 100% Full Time. Highlights an 5% In-person, and 95% Remote job distribution, with an average salary of $82,217 per year, or $39.5 per hour.

Medical Director (REMOTE Appeals Medical Director - Pacific Standard Time, Managed Care Experience,

CareSource

Dayton, OH • On-site, Remote

$195K - $341K/yr

Full-time

Re-posted 27 days ago

CareSource rating

7.7

Company rating: 7.7 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

205th of 311 rated insurance

Job description

Job Summary:
The Medical Director is responsible for supporting staff by providing training, clinical consultation, and clinical case review for members.
Essential Functions:
  • Provide prior authorization medical reviews, consultation and clinical review services
  • Participate in peer-to-peer discussions
  • Provide provider education, training, data sharing, performance evaluations and orientation to the plan
  • Conduct clinical reviews for designated CareSource members as requested
  • Provide physician review for clinical appeals cases
  • Participate in the evaluation and investigations of cases suspected of fraud, abuse, and quality of care concerns
  • Participate in development of policies and procedures
  • Participates in quality improvement initiatives, case management activities and member safety activities (i.e. incident management
  • Provide cross-coverage for other Medical Directors and/or markets, as needed
  • Oversight and quality improvement activities associated with case management activities
  • Assist in the review of utilization data to identify variances in patterns, and provide feedback and education to MCP staff and providers as appropriate
  • Participate in the development, implementation and revision of the clinical care standards and practice guidelines ensuring compliance with nationally accepted quality standards
  • Participate in the development, implementation and revision of the Quality Improvement Plan and corporate level quality initiatives
  • Collaborate with market/product leaders to help define market strategy
  • Community collaborative participation
  • Support of regulatory and accreditation functions (eg. CMS, State, NCQA and URAC) and compliance for all programs
  • Perform any other job related instructions, as requested

Education and Experience:
  • Completion of an accredited Medical Degree program as a medical doctor (MD) or Doctor of Osteopathic (DO) medicine is required
  • Successful completion of a residency training program, preferably in primary care is required
  • Minimum of five (5) years of clinical practice experience is required
  • Managed care medical review/medical director experience is preferred
  • Bachelor's or Master's degree in Business Administration, Operational Excellence, Healthcare Administration or Medical Management is preferred

Competencies, Knowledge and Skills:
  • Basic Microsoft Word skills
  • Excellent communication skills, both written and oral
  • Ability to work well independently and within a team environment
  • Ability to create strong relationships with Providers and Members
  • High ethical standards
  • Attention to detail
  • Critical listening and systematic thinking skills
  • Ability to maintain confidentiality and act in the company's best interest
  • Ability to act with diplomacy and sensitivity to cultural diversity
  • Decision making/problem solving skills
  • Conflict resolution skills
  • Strong sense of mission and commitment of time, effort and resources to the betterment of the communities served

Licensure and Certification:
  • Current, unrestricted license to practice medicine in state of practice as necessary to meet regulatory requirements is required
  • Board Certification, preferably in primary care specialty is required
  • Re-certification, as required by specialty board, must be maintained (exceptions may be granted by Chief Medical Officer)
  • MCG Certification is required or must be obtained within six (6) months of hire

Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time
  • May be required to work evenings/weekends
  • May be required to travel to fulfill duties of position

Compensation Range:
$195,200.00 - $341,600.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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Brand=CareSource

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