A healthcare services providerHiring

Appeals and Grievances Clinical Specialist

  • Remote, United States
  • Mid-level
  • Posted 2 weeks ago
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In one line

Clinical role managing member complaints and appeals, ensuring compliance with federal and state regulations.

About the role

This position involves investigating and resolving clinical cases, preparing cases for review, and managing regulatory timelines.

At a glance

Pay
Not stated in the posting
Remote scope
Remote, United States
Seniority
Mid-level
Skills
Microsoft Word, Utilization Review
Posted
21 Oct 2026
Last checked
27 Oct 2026

What you will do

  • Develop and resolve clinical cases
  • Prepare cases for Medical Director review
  • Manage regulatory timelines and documentation
  • Communicate effectively with colleagues

What they look for

  • RN, LPN, or Dental Hygienist license
  • Experience in appeals and grievances or claims processing
  • Proficiency in Microsoft Word and Excel
  • Ability to manage large caseloads

Nice to have

  • Bachelor's degree

How Keywordise applies for you

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  2. 2Tailored to this jobKeywordise writes a CV and a cover letter for this job from your real experience.
  3. 3The form fills itselfName, email, experience and screening questions, field by field.
  4. 4Application sentYou get a receipt and follow it in your dashboard.

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ClaudeConnectorChatGPTConnectorMuseby Meta

Claude

  1. In Claude, open Settings, then Connectors, and choose Add custom connector.
  2. Name it Keywordise and paste the connector URL.
  3. Click Connect, log in to Keywordise and approve. Then send the prompt in a new chat.
Connector URL
https://keywordise.com/mcp

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ChatGPT

  1. In ChatGPT, open Settings, then Connectors. On plans that need it, turn on developer mode first.
  2. Add a new connector with the connector URL and choose OAuth. Leave the client ID and secret empty.
  3. Log in to Keywordise and approve. Then send the prompt in a new chat.
Connector URL
https://keywordise.com/mcp

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Muse

  1. Open Muse (muse.ai or the app) and send it the message below.
  2. If Muse asks how to sign in, answer OAuth. Open the sign-in link it sends, log in to Keywordise and approve.
  3. Send the prompt. Muse asks before it sends anything.
Message for Muse
Add a custom connector called Keywordise. It is a remote MCP server at https://keywordise.com/mcp and uses OAuth. Give me the sign-in link.

Muse is available in the US only for now.

Prompt
Apply to Keywordise job q262fpfbyq
How to connect

Questions about this job

Is this a remote job, and where can I work from?

Yes, it is listed as remote, aimed at candidates in the United States.

What does this job pay?

No pay range is stated in the posting.

What experience is needed?

It is a mid-level role. The posting asks for: RN, LPN, or Dental Hygienist license; experience in appeals and grievances or claims processing; proficiency in Microsoft Word and Excel. Skills it names include Microsoft Word, Utilization Review.

How do I apply with Keywordise AI?

Click Apply with Keywordise AI, create an account and upload your CV. Your CV and cover letter are written for this job from what you have really done, then Keywordise applies for you. Trial: 7 days, no card.

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