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Remote Grievance Analyst Jobs (NOW HIRING)

BCForward

Grievance & Appeals Coordinator I

Iowa, IA · Remote

$19.77/hr

Remote (Iowa Residents Only) Duration: 6-Month Contract (Extension Possible) Schedule: Monday ... Gather, analyze, investigate, and document verbal and written member and provider complaints ...

Humana, Inc.

Medical Director Grievances & Appeals

Serve as a clinical resource for grievance and appeals staff, providing guidance and education as ... Possess analysis and interpretation skills with prior experience leading teams focusing on quality ...

Avesis

Appeals and Grievances Coordinator

Phoenix, AZ · Remote

$21.25 - $26.25/hr

Analyze medical records, supporting documentation, and applicable guidelines to make informed ... As this role is a remote role, you are required to maintain internet service that allows you to ...

Avēsis

Appeals and Grievances Coordinator

$22.50 - $28/hr

Analyze medical records, supporting documentation, and applicable guidelines to make informed ... As this role is a remote role, you are required to maintain internet service that allows you to ...

ADM

Labor Relations Manager - Remote

Decatur, IL · Remote

Labor Relations Manager Remote - U.S.(Located within reasonable distance of an airport for frequent ... Track and analyze grievance trends to identify root causes and preventative actions.Union Activity ...

Archer Daniels Midland

Labor Relations Manager Remote - U.S. (Located within reasonable distance of an airport for ... Track and analyze grievance trends to identify root causes and preventative actions. Union Activity ...

Directv

Lead, Labor Relations

El Segundo, CA · Remote

Analyze complex and ambiguous contractual language to deliver clear, actionable recommendations ... Grievance and Dispute Management * Lead the end-to-end grievance process across multiple business ...

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Remote Grievance Analyst information

How does a Remote Grievance Analyst typically collaborate with other departments to resolve member issues?

As a Remote Grievance Analyst, you’ll regularly coordinate with departments such as claims, customer service, and medical management to thoroughly investigate and resolve member grievances. Effective communication through virtual meetings, emails, and shared documentation is key to gathering the necessary information and ensuring all perspectives are considered. This collaborative approach helps to address member concerns efficiently and ensures compliance with regulatory requirements. Being proactive and detail-oriented will help you build strong working relationships and contribute to positive outcomes for both members and the organization.

What are the key skills and qualifications needed to thrive as a Remote Grievance Analyst, and why are they important?

To thrive as a Remote Grievance Analyst, you need expertise in claims processing, regulatory compliance, and case management, typically supported by a bachelor's degree in a relevant field or equivalent experience. Familiarity with case management systems, health plan software, and knowledge of Medicaid/Medicare regulations is commonly required. Attention to detail, analytical thinking, and effective written communication are critical soft skills for investigating and resolving member or provider complaints. These skills are essential to ensure fair, timely resolutions, maintain compliance, and uphold member satisfaction in a remote work environment.

What is the difference between Remote Grievance Analyst vs Remote Customer Service Representative?

AspectRemote Grievance AnalystRemote Customer Service Representative
Required CredentialsTypically requires a bachelor's degree in HR, social sciences, or related fields; certifications in conflict resolution are a plusHigh school diploma or equivalent; customer service or communication certifications beneficial
Work EnvironmentPrimarily analytical, reviewing complaints, and resolving disputes within HR or legal frameworksDirect interaction with customers via phone, email, or chat to address inquiries and resolve issues
Employer & Industry UsageUsed mainly in HR, legal, or corporate compliance departmentsCommon across retail, tech, healthcare, and service industries

The main difference is that Remote Grievance Analysts focus on reviewing and resolving employee or customer complaints within HR or legal contexts, requiring analytical skills and specific certifications. In contrast, Remote Customer Service Representatives primarily handle direct customer interactions to solve issues, emphasizing communication skills. Both roles are remote but serve different functions within organizations.

What is a Remote Grievance Analyst?

A Remote Grievance Analyst is a professional who reviews, investigates, and resolves complaints or grievances, often related to healthcare, insurance, or employee relations, while working from a remote location. They analyze cases, ensure compliance with relevant regulations and company policies, and communicate findings and outcomes to involved parties. This role typically requires strong analytical, communication, and problem-solving skills, as well as the ability to work independently. Remote Grievance Analysts play a key role in ensuring fairness and accountability in organizational processes.
More about Remote Grievance Analyst jobs
What cities are hiring for Remote Grievance Analyst jobs? Cities with the most Remote Grievance Analyst job openings:
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Remote Grievance Analyst jobs near you
Infographic showing various Remote Grievance Analyst job openings in the United States as of June 2026, with employment types broken down into 15% Locum Tenens, 4% Internship, 7% As Needed, 29% Full Time, 4% Temporary, and 41% Contract. Highlights an 81% Physical, 8% Hybrid, and 11% Remote job distribution.
Appeal and Grievance Coordinator

Appeal and Grievance Coordinator

Workforce Connections

Woodland Hills, CA • Remote

$23/hr

Contractor

Posted 24 days ago

Job description

Grievance & Appeals Coordinator I

Location: Remote (California) — Candidates should live within reasonable distance of the Woodland Hills or Natomas offices
Schedule: Monday–Friday, 8:00 AM–5:00 PM (overtime as needed; occasional weekends/holidays)
Duration: 12-month assignment with potential to extend or convert
Pay Rate: $23/hour

Position Summary

The Grievance & Appeals Coordinator supports the resolution of member and provider grievances and appeals by analyzing claims, authorizations, and formal complaints. This role ensures timely, accurate case handling while maintaining high quality and compliance standards.

Key Responsibilities

  • Review, analyze, and resolve verbal and written grievances and appeals from members and providers

  • Prepare clear, professional written response letters

  • Maintain accurate files and documentation for all cases

  • Track and manage large volumes of case-related documents

  • Support committee coordination related to grievance and appeals processes

  • Assist with quality initiatives, including performance tracking and reporting

  • Support HEDIS-related activities such as data entry, provider outreach, and claims research

  • Collaborate closely with team members to meet quality, accuracy, and turnaround benchmarks

Qualifications

Required:

  • High school diploma or equivalent

  • 2–3 years of experience in grievances and appeals, claims, healthcare administration, or a regulated healthcare environment

  • Strong written, verbal, and problem-solving skills

  • High attention to detail and ability to manage multiple cases simultaneously

Preferred:

  • Associate’s degree

  • Knowledge of healthcare regulations (e.g., Medicare/Medicaid)

  • Experience handling complex or compliance-related cases

  • Strong letter-writing and documentation skills

  • Conflict resolution or cross-functional coordination experience

Performance Expectations

  • Meet or exceed 97% quality and accuracy standards

  • Resolve cases efficiently while maintaining compliance and customer satisfaction

  • Communicate effectively and collaborate across teams

Ideal Candidate Traits

  • Detail-oriented and organized

  • Professional, empathetic communicator

  • Analytical and solution-focused

  • Comfortable working independently in a remote environment while staying engaged with the team

CLIENT does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.