New Jersey Licensed Medical Policy Analyst

Job Summary

A company is looking for a Medical Policy Analyst.

Key Responsibilities:

• Provide timely and accurate responses to inquiries related to claims and medical reviews
• Prepare cases for Medical Director and outside consultant review
• Identify opportunities for development or revisions to medical policy based on case reviews

Required Qualifications:

• High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree
• Minimum of 2 years clinical experience required
• 3 years experience in the health care delivery system/industry required
• Active Unrestricted RN License required; NJ License preferred
• Certified Professional Coder credentials preferred