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Clinical Resolution Analyst Jobs in Crofton, MD (NOW HIRING)

J29 Inc.

Dispute Resolution Analyst I

Millersville, MD · On-site +1

$16.25 - $18.25/hr

Dispute Resolution Analyst Overview: J29, Inc. (J29) has been supporting commercial, State, and ... and clinical expertise. Our team is experienced in program, payment, provider, and patient ...

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Clinical Analyst JobLocation:Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US ... Case investigation / issue resolution * Excel and reporting * SOP/process documentation * Strong ...

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Clinical Analyst JobLocation:Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US ... Case investigation / issue resolution * Excel and reporting * SOP/process documentation * Strong ...

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Job Title: Clinical Analyst Job Location: Remote Job Duration: Contract / FTE Client: Federal ... Case investigation / issue resolution * Excel and reporting * SOP/process documentation * Strong ...

Global Alliant Inc

Clinical Analyst

Baltimore, MD · On-site

Job Title: Clinical Analyst Job Location: Remote Job Duration: Contract / FTE Client: Federal ... Case investigation / issue resolution * Excel and reporting * SOP/process documentation * Strong ...

Ibility

Clinical Informaticists II

Washington, DC · On-site +1

Support reporting and analytics by analyzing clinical and operational data, developing reports and ... issue resolution and operational stability. * Support interoperability, archiving, and data ...

New

Ibility

Clinical Informaticists II

Washington, DC · Remote

Support reporting and analytics by analyzing clinical and operational data, developing reports and ... issue resolution and operational stability. * Support interoperability, archiving, and data ...

New

Ibility

Clinical Informaticists II

Washington, DC

Support reporting and analytics by analyzing clinical and operational data, developing reports and ... issue resolution and operational stability. * Support interoperability, archiving, and data ...

New

EDJ Associates,

Protocol Data Analyst I

Washington, DC · On-site

... resolution through the ServiceNow ticketing system. • Participate in the review of clinical research protocols, reports, and statistical analysis plans. • Support quality assurance and data ...

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Showing results 1-20

All JobsClinical Resolution Analyst JobsClinical Resolution Analyst Jobs in Crofton, MD

Clinical Resolution Analyst information

See Crofton, MD salary details

$16

$28

$46

How much do clinical resolution analyst jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for clinical resolution analyst in Crofton, MD is $28.22, according to ZipRecruiter salary data. Most workers in this role earn between $23.32 and $34.52 per hour, depending on experience, location, and employer.

What is the difference between Clinical Resolution Analyst vs Medical Claims Specialist?

AspectClinical Resolution AnalystMedical Claims Specialist
Required CredentialsHealthcare-related certifications, clinical knowledgeMedical billing/coding certifications, insurance knowledge
Work EnvironmentHealthcare facilities, insurance companiesMedical offices, insurance companies, billing centers
Employer & Industry UsageHospitals, healthcare providers, insurance firmsInsurance companies, healthcare billing services
Common Search & ComparisonYesNo

The Clinical Resolution Analyst primarily focuses on resolving clinical and patient-related issues, often requiring healthcare knowledge and clinical certifications. In contrast, a Medical Claims Specialist handles billing, coding, and claims processing. While both roles work within healthcare and insurance environments, their core responsibilities differ, making this comparison relevant for those exploring healthcare support careers.

How does a clinical resolution analyst typically collaborate with healthcare providers and insurance teams to resolve patient cases?

A Clinical Resolution Analyst frequently acts as a liaison between healthcare providers, insurance teams, and patients to address complex clinical or billing issues. They review medical records, insurance claims, and provider notes to investigate discrepancies or denials, and then communicate findings and solutions to all parties involved. This collaborative process often involves regular meetings, detailed documentation, and coordination with clinical staff to ensure accurate and timely case resolution. Building strong relationships with both internal and external stakeholders is key to success in this role.

What are the key skills and qualifications needed to thrive as a clinical resolution analyst, and why are they important?

To thrive as a Clinical Resolution Analyst, you need a strong background in healthcare administration or clinical practice, analytical thinking, and problem-solving skills, often supported by a relevant degree or certification. Familiarity with electronic health records (EHR) systems, claims processing platforms, and healthcare compliance regulations is crucial. Excellent communication, attention to detail, and the ability to collaborate across departments are important soft skills for this role. These competencies ensure accurate case resolution, regulatory compliance, and effective communication between providers, payers, and patients.

What is a clinical resolution analyst?

A Clinical Resolution Analyst is a healthcare professional who reviews, investigates, and resolves clinical issues or complaints, often related to healthcare claims, patient care, or provider services. They work closely with clinical teams, insurance companies, and patients to ensure accurate and efficient resolution of clinical concerns. Their responsibilities may include analyzing medical records, interpreting clinical guidelines, and communicating outcomes to stakeholders. This role requires strong analytical skills, attention to detail, and knowledge of healthcare regulations and terminology.
What cities near Crofton, MD are hiring for Clinical Resolution Analyst jobs? Cities near Crofton, MD with the most Clinical Resolution Analyst job openings:
Clinical Resolution Analyst jobs near you

Dispute Resolution Analyst I

J29 Inc.

Millersville, MD • On-site, Remote

$16.25 - $18.25/hr

Full-time

Re-posted 5 days ago

Job description

Position: Dispute Resolution Analyst
Overview:
J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since company inception in 2017 as a healthcare management consulting company. Our team of 260 employees focuses on providing processing, review, and analysis of medical claims, records, data, and audits between areas of compliance, policy, and clinical expertise. Our team is experienced in program, payment, provider, and patient integrity as we continue to support advanced programs of policy, clinical requirements, and compliance measures at the commercial, State, and Federal levels.
J29 was founded to be an employee-centric company that prioritizes the well-being and value of its employees. Our mission is to empower our employees to do great things for the benefit of those that need it most. The J29 mission supports not only our health and human service programs, but also the philanthropy efforts of our team. We are proud to continue our support to non-profit groups with critical missions as J29 continues to grow.
Position:
As a Dispute Resolution Analyst (DRA) you'll support the Independent Dispute Resolution (IDR) programs that handle routine 'Surprise Billing' appeals work. This role will serve as a support person for the reconsideration/dispute resolution professionals and physician reviewers for second level reconsiderations/dispute resolutions. Additionally, the DRA position will work under close supervision, with minimal latitude for the use of initiative and independent judgement
Role & Responsibilities:
  • Coordinates the delivery of re-determination files/dispute resolution documents and reconsideration/dispute resolution decisions from and to the external entities.
  • Builds a reconsideration/dispute resolution case file from evidence submitted and received and analyzes each case to ensure it meets the requirements for a valid reconsideration/dispute resolution request as mandated by Centers for Medicare and Medicaid Services (CMS) or other customer entities.
  • Analyzes and makes decisions based on medical vs. non-medical case type, appeal/review categories, validity of appeal/dispute resolution request, and dispute resolution settlement documentation.
  • Inputs appropriate data regarding reconsiderations/dispute resolution cases into the applicable required systems.
  • Responds to reconsideration/dispute review requests from appellants/patients/providers.
  • Routes or responds to telephonic and/or written inquiries from appellants/patients about reconsiderations/dispute resolution or about the reconsiderations/dispute resolutions process from appellants/patient or their legally-designated representatives.
  • Identifies any suspected instances of fraud and/or abuse and immediately inform management of such issues.
  • Stays abreast of changes in regulations and practices, policies and procedures
  • May submit requests for re-determination files and completed reconsideration and Administrative Law Judge (ALJ) decisions to relevant entities.
  • Participates in special projects and performs other duties as assigned.

Experience / Expertise:
  • One (1) years of experience with Provider disputes or claims
  • One (1) years of interaction with claims with larger insurance plans
  • One (1) year of general office or administrative experience
  • Experience directly relevant to the specific task order or project, preferred

Education:
• High School Diploma or equivalent
Location: Remote
Salary: $16.25-18.25 per hour
J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal
Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex,
sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other
protected class. J29, Inc. is a proud Veteran friendly employer.
J29 logo

About J29

Sourced by ZipRecruiter

Industry

Business management consulting

Company size

1 - 10 Employees

Headquarters location

Millersville, MD, US

Year founded

2017

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