Clinical Appeals Reviewer - Ontario, CA

Adecco Medical & Science is hiring a REMOTE Clinical Appeals Representative for a healthcare organization based in Ontario, CA This is a 100% remote opportunity with occasional in-office visits to process mail at the Ontario location. Position Details: u2022 Type: Contract position u2022 Schedule: Monday u2013 Friday, 8:00 AM u2013 4:30 PM (training hours same as regular schedule) u2022 Pay: $24 to $26 (26.30/hour) /hr Key Responsibilities: u2022 Serve as the point of contact for Health Plan member grievances and potential quality of care issues (PQIs) u2022 Coordinate the intake and initial processing of member grievances and quality of care concerns from internal and external sources u2022 Perform data entry, record requests, and follow-ups while maintaining required documentation in databases u2022 Communicate with provider offices and other entities to ensure documentation is received on time u2022 Manage turnaround times (TATs) within Health Plan timelines (ranging from 24 hours to 10 days, depending on request type) Qualifications: u2022 High School Diploma or GED required u2022 Strong organizational and communication skills u2022 Prior healthcare or insurance experience preferred Why work for Adecco? u2022 Excellent Weekly Pay u2022 401(k) Plan u2022 Skills Training u2022 Excellent Medical, Dental, and Vision Benefits Pay Details: $24.00 to $26.00 per hour Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable. Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable: + The California Fair Chance Act + Los Angeles City Fair Chance Ordinance + Los Angeles County Fair Chance Ordinance for Employers + San Francisco Fair Chance Ordinance Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Created: 2026-03-16