North Carolina Licensed Appeals Analyst

Job Summary

A company is looking for an Appeals Analyst to work remotely for a highly accredited health insurance organization.

Key Responsibilities

• Analyze, research, resolve, and respond to appeals, coding disputes, grievances, and coverage determinations
• Prepare files and develop position statements for external reviews by independent organizations
• Document investigations and findings in applicable systems while ensuring compliance with regulatory standards

Required Qualifications

• Bachelor's degree or advanced degree where required
• 3 years of related experience, or 5 years in lieu of a degree
• CPC certification required
• Must reside in approved states (NC preferred, among others)