Medicare Appeals Analyst

Job Summary

Conducting second-level non-medical Medicare appeals decisions, the full-time Reconsideration Analyst II will review appeal cases, write clear decisions, and ensure compliance with regulations while working remotely from anywhere in the USA.

Key responsibilities

• Write non-medical reconsideration decisions that clearly support the determinations made
• Address all appeal issues raised by parties involved, ensuring fair and impartial decisions
• Conduct research using federal regulations and Medicare policies to support accurate decision-making

Required qualifications

• High School Diploma or equivalent
• Two years of general office experience, with education in administration or related fields as a substitute
• One year of experience in Medicare appeals or Managed Care appeals
• Experience relevant to Medicare managed care appeals or utilization management is preferred