ALJ Appeals Analyst

Job Summary

A company is looking for an ALJ Analyst to monitor contractor interactions and support reconsideration decisions.

Key Responsibilities

• Review Administrative Law Judge (ALJ) Remand Orders and associated case files to resolve issues
• Perform data analysis on cases returned to higher-level appeal authority and document outcomes
• Develop formal documentation with findings and recommendations to improve guidelines and reduce overturned cases

Required Qualifications

• High School Diploma or equivalent
• Three (3) years of general office experience, with education in analytics, administration, or healthcare substituting for experience on a year-per-year basis
• One (1) year of experience in Medicare appeals
• Preferred experience in Managed Care
• Resided in the United States for a minimum of three (3) years out of the last five (5) years