One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
$15.25 - $17.75/hr
Review, process, and update undergraduate applications to ensure accuracy and completeness in Banner, Slate, and related systems. *Manage application updates, workflow modifications, and record ...
$15.25 - $17.75/hr
Review, process, and update undergraduate applications to ensure accuracy and completeness in Banner, Slate, and related systems. *Manage application updates, workflow modifications, and record ...
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
Madison, WI ยท On-site
$22.50/hr
Application Review Specialist Job Summary: Come join our team in the Office of Admissions and Recruitment! We are admissions professionals dedicated to recruiting, admitting, and enrolling the next ...
Madison, WI ยท On-site
$22.50/hr
Application Review Specialist Job Summary: Come join our team in the Office of Admissions and Recruitment! We are admissions professionals dedicated to recruiting, admitting, and enrolling the next ...
Blacksburg, VA ยท On-site
$37K/yr
Review, process, and update undergraduate applications to ensure accuracy and completeness in Banner, Slate, and related systems. *Manage application updates, workflow modifications, and record ...
Blacksburg, VA ยท On-site
$37K/yr
Review, process, and update undergraduate applications to ensure accuracy and completeness in Banner, Slate, and related systems. *Manage application updates, workflow modifications, and record ...
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting * Knowledge and ...
New
Bloomington, IL ยท On-site
$70K - $99K/yr
... application. Failure to upload requested transcripts, license and/or proof of certification when ... Reviews compliance with program standards. Essential Functions * Performs comprehensive, detailed ...
Bloomington, IL ยท On-site
$70K - $99K/yr
... application. Failure to upload requested transcripts, license and/or proof of certification when ... Reviews compliance with program standards. Essential Functions * Performs comprehensive, detailed ...
Madison, WI ยท On-site +1
$22.50/hr
Application Review Specialist Job Summary: Come join our team in the Office of Admissions and Recruitment! We are admissions professionals dedicated to recruiting, admitting, and enrolling the next ...
Madison, WI ยท On-site +1
$22.50/hr
Application Review Specialist Job Summary: Come join our team in the Office of Admissions and Recruitment! We are admissions professionals dedicated to recruiting, admitting, and enrolling the next ...
Madison, WI ยท On-site +1
$22.50/hr
Application Review Specialist Job Summary: Come join our team in the Office of Admissions and Recruitment! We are admissions professionals dedicated to recruiting, admitting, and enrolling the next ...
Madison, WI ยท On-site +1
$22.50/hr
Application Review Specialist Job Summary: Come join our team in the Office of Admissions and Recruitment! We are admissions professionals dedicated to recruiting, admitting, and enrolling the next ...
Bloomington, IL ยท On-site
$70K - $99K/yr
... application. Failure to upload requested transcripts, license and/or proof of certification when ... Reviews compliance with program standards. Essential Functions * Performs comprehensive, detailed ...
Bloomington, IL ยท On-site
$70K - $99K/yr
... application. Failure to upload requested transcripts, license and/or proof of certification when ... Reviews compliance with program standards. Essential Functions * Performs comprehensive, detailed ...
$70K - $99K/yr
... application. Failure to upload requested transcripts, license and/or proof of certification when ... Reviews compliance with program standards. Essential Functions * Performs comprehensive, detailed ...
$70K - $99K/yr
... application. Failure to upload requested transcripts, license and/or proof of certification when ... Reviews compliance with program standards. Essential Functions * Performs comprehensive, detailed ...
$39.5K - $54.3K
2% of jobs
$54.3K - $69K
7% of jobs
$69K - $83.8K
7% of jobs
$94.9K is the 25th percentile. Wages below this are outliers.
$83.8K - $98.6K
11% of jobs
$98.6K - $113.4K
15% of jobs
The median wage is $119.4K / yr.
$113.4K - $128.1K
18% of jobs
$138.6K is the 75th percentile. Wages above this are outliers.
$128.1K - $142.9K
20% of jobs
$142.9K - $157.7K
13% of jobs
$157.7K - $172.5K
5% of jobs
$172.5K - $187.2K
1% of jobs
$187.2K - $202K
0% of jobs
$39.5K
$121.5K
$202K
| Aspect | Application Reviewer | Application Analyst |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require a bachelor's degree | Bachelor's degree in related field; certifications may be preferred |
| Work Environment | Office setting, often in government or corporate sectors | Office or remote, analyzing data and processing applications |
| Employer & Industry Usage | Used in government agencies, healthcare, and finance sectors | Common in IT, finance, and administrative sectors |
| Search & Comparison Intent | Understanding job duties and qualifications for application review roles | Comparing roles involving data analysis and application processing |
Application Reviewers primarily evaluate applications for completeness and eligibility, focusing on initial screening. Application Analysts perform more in-depth data analysis, interpret application data, and may recommend decisions. While both roles involve reviewing applications, Analysts typically require more technical skills and higher education, and their work involves detailed data analysis beyond initial screening.

Boise, ID โข On-site
Other
This job post hasย expired today.ย Applications are no longer accepted.
Medicare Appeals Reviewer I (Dispute Resolution Reviewer I)
Fully RemoteโขUnited States
Job Type
Full-time
Description
Overview
Tanaq Support Services (TSS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TSS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders.
About the Role
We are seeking a Medicare Appeals Reviewer I (Dispute Resolution Reviewer I) to support our federal client. In this role, you will review Medicare enrollment appeal and rebuttal cases, evaluate supporting documentation and evidence, and issue independent determinations based on applicable laws, regulations, policies, and guidelines.
This role will work under general supervision, with moderate latitude for initiative and independent judgment.
This is a remote position that can be based anywhere in the United States; candidates must reside in the United States.
Responsibilities
Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review
Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy
Responds to and ensures that all issues raised by the beneficiary, representative, supplier, and provider have been addressed
Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures
Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision
Stays abreast of changes in regulations, medical and healthcare practices, policies and procedures
Participates in special projects and performs other duties as assigned
Requirements
Required Experience and Skills
One (1) year of Medicare appeals, medical review, clinical, healthcare regulatory interpretation/application, healthcare compliance or related experience in a healthcare setting
Knowledge and experience following HIPAA regulations and personally identifiable information (PII).
Experience using Microsoft 365, including Excel and Word.
Must be able to pass Federal and state criminal background checks, as required by client.
Must be able to pass a drug screen, as required by the client.
Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.
Preferred Qualifications
Experience working within the federal public health agency environment.
Experience in appeals and billing.
Previous CMS guidelines or manual knowledge, particularly with the No Surprises Act.
Medical Coding certified.
Education and Training
Associateโs degree or 60 or more credit hours towards a Bachelorโs degree from an accredited college or university in healthcare or related discipline.
Experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for an Associateโs degree on a year-for-year basis (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent)
Physical Requirements
Who We Are
Tanaq Support Services (TSS) is a public health contractor, certified 8(a) business, owned by St. George Tanaq Corporation, an Alaska Native Corporation. (ANC). We listen to our stakeholders and leverage our science, technology, communication, and program expertise to understand and provide feedback as we develop solutions.
Our Commitment to Non-Discrimination
Tanaq Support Services is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to disability, status as a protected veteran or any other status protected by applicable federal, state, or local law. Tanaq complies with the Drug-free Workplace Act of 1988 and E-Verify.
If you are an individual with a disability and need assistance completing any part of the application process, please email accommodation@tanaq.com to request a reasonable accommodation. This email is for accommodation requests only and cannot be used to inquire about the status of applications.
Notice on Candidate AI Usage
Tanaq is committed to ensuring a fair and competitive interview process for all candidates based on their experience, skills and education. To ensure the integrity of the interview process, the use of artificial intelligence (AI) tools to generate or assist with responses during phone, in person and virtual interviews is not allowed. However, candidates who require a reasonable accommodation that may involve AI are required to contact us prior to their interview at accommodation@tanaq.com.
To view this and all our job postings, visit us at:
https://recruiting.paylocity.com/recruiting/jobs/All/a4712c9f-f074-40e8-9a14-bee06660bd81/Tanaq-Support-Services-LLC
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Business management consulting
1 - 10 Employees
Anchorage, AK, US
1973