Clinical Appeals Analyst

in Pharma Contract

Job Detail

  • Experience Level Mid Level
  • Degree Type Bachelor of Arts (BA)
  • Employment Consulting
  • Working Type Remote
  • Job Reference 0000008724
  • Salary Type Hourly
  • Industry Healthcare
  • Selling Points

    Join our team as a Clinical Appeals Analyst to analyze and resolve clinical appeals efficiently, ensuring compliance and accuracy in all reviews.

Job Description

Appeals Analyst

Initially this role will be more of an intake specialist role, which will be reviewing appeals from the que and assigning to the Appeals Analyst for volume support. Once volume becomes more manageable the resources will move to move of an Appeals Analyst role.

Volume expectation is 35 to 45 cases a day to be triaged

Candidates need to have strong MS Office experience.

Experience with Care Radius, and Diagnosis codes is a plus.

All letters are system generated and typing evaluations are not required

Candidates should be familiar with Right Fax/E-fax

Training is 2 weeks initially, but a SME will be available for support throughout the assignment.

Hiring Requirements:

  • Bachelor’s degree or advanced degree where required.
  • 3 years of related experience
  • In lieu of degree, 5 years of related experience
  • ShareAustin:

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