ALJ Analyst

Job Summary

Working remotely on a full-time basis, the ALJ Analyst will monitor contractor interactions regarding reconsideration decisions, assist in data analysis and documentation of appeal cases, and develop recommendations to improve guidelines and reduce overturned cases.

Key responsibilities

• Review Administrative Law Judge (ALJ) Remand Orders and associated case files to determine necessary resolution steps
• Perform data analysis on cases returned to higher-level appeal authority, documenting outcomes and reasons for overturns
• Track and monitor requests, ensuring timely returns to the appropriate higher-level appeal authority

Required qualifications

• High School Diploma or equivalent
• Three years of general office experience, with potential substitution of education in analytics, administration, or healthcare
• One year of experience in Medicare appeals
• Preferred experience in Medicare Part C related appeals activities
• Residency in the United States for a minimum of three out of the last five years