Reconsideration Analyst

Job Summary

A company is looking for a Reconsideration Analyst I.

Key Responsibilities

• Coordinates delivery of appeals case files and reconsideration decisions
• Builds and analyzes reconsideration case files to ensure compliance with CMS requirements
• Responds to inquiries from appellants and identifies suspected fraud or abuse

Required Qualifications

• High School Diploma or equivalent
• One year of general office experience or equivalent education in administration or business
• Preferred experience in Medicare managed care appeals or utilization management
• Some knowledge of Medicare appeals programs and applicable laws
• Ability to meet production and quality standards while multitasking