Hopewell, NJ · On-site
$42 - $45/hr
Appeal Analyst RN who will train new hire in the clinical role to complete Utilization Management ... This position is responsible for handling all Utilization Management medical appeal cases. Ensures ...
Hopewell, NJ · On-site
$42 - $45/hr
Appeal Analyst RN who will train new hire in the clinical role to complete Utilization Management ... This position is responsible for handling all Utilization Management medical appeal cases. Ensures ...
Pennington, NJ · On-site
$40 - $42/hr
Appeal Analyst RN I Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension ... Analyze and identify error trends related to medical record documentation, billing documentation ...
Pennington, NJ · On-site
$40 - $42/hr
Appeal Analyst RN I Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension ... Analyze and identify error trends related to medical record documentation, billing documentation ...
Hopewell, NJ · On-site
$40 - $42/hr
Appeal Analyst RN I Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension ... Analyze and identify error trends related to medical record documentation, billing documentation ...
Hopewell, NJ · On-site
$40 - $42/hr
Appeal Analyst RN I Job Location: Hopewell, NJ Job Duration: 6 Months (possibility of extension ... Analyze and identify error trends related to medical record documentation, billing documentation ...
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Sturtevant, WI · On-site
$24 - $26/hr
Conduct statistical analysis of complaint trends. * Support training program by training users on ... Medical or Surgical Office Experience (preferred) Customer Service Experience (preferred) Knowledge ...
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Sturtevant, WI · On-site
$24 - $26/hr
Conduct statistical analysis of complaint trends. * Support training program by training users on ... Medical or Surgical Office Experience (preferred) Customer Service Experience (preferred) Knowledge ...
Appeal Analyst RN | Contract Walker Healthforce is seeking an Appeal Analyst RN with a minimum of 3 ... Medical, Dental & Vision available * 401k options Why Work With Walker? * Access to our top ranked ...
Appeal Analyst RN | Contract Walker Healthforce is seeking an Appeal Analyst RN with a minimum of 3 ... Medical, Dental & Vision available * 401k options Why Work With Walker? * Access to our top ranked ...
Springfield, MA · On-site
$52K - $58K/yr
Gather, review, and maintain documentation needed to support appeal and complaint responses ... Strong aptitude and familiarity with medical coding and medical terminology. * Strong understanding ...
Springfield, MA · On-site
$52K - $58K/yr
Gather, review, and maintain documentation needed to support appeal and complaint responses ... Strong aptitude and familiarity with medical coding and medical terminology. * Strong understanding ...
$80 - $100/hr
... appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in ...
$80 - $100/hr
... appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in ...
Carolina, RI · On-site +1
... appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in ...
Carolina, RI · On-site +1
... appeal requests. Provides thorough clinical review or benefit analysis to determine if the requested services meet medical necessity guidelines. Documents decisions within mandated timeframes and in ...
Chapel Hill, NC · On-site
$73K - $117K/yr
Note: This job reports to Manager, Nursing or Team Leader, Medical only. WhatYou'llDo * Provide ... appeal guidelines and/or CMP. * Answer member/provider questions via incoming telephone calls in a ...
Chapel Hill, NC · On-site
$73K - $117K/yr
Note: This job reports to Manager, Nursing or Team Leader, Medical only. WhatYou'llDo * Provide ... appeal guidelines and/or CMP. * Answer member/provider questions via incoming telephone calls in a ...
$73K - $117K/yr
Note: This job reports to Manager, Nursing or Team Leader, Medical only. WhatYou'llDo * Provide ... appeal guidelines and/or CMP. * Answer member/provider questions via incoming telephone calls in a ...
$73K - $117K/yr
Note: This job reports to Manager, Nursing or Team Leader, Medical only. WhatYou'llDo * Provide ... appeal guidelines and/or CMP. * Answer member/provider questions via incoming telephone calls in a ...
$66K - $110K/yr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
$66K - $110K/yr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
Newark, NJ · On-site
$66K - $110K/yr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
Newark, NJ · On-site
$66K - $110K/yr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
Newark, NJ · On-site
$66K - $110K/yr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
Newark, NJ · On-site
$66K - $110K/yr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
Durham, NC · On-site
$80 - $100/hr
Coordinate all aspects of the appeals process to ensure compliance with medical necessity criteria ... Analyze complex/non-routine member and provider appeals and grievances for all lines of business ...
New
Durham, NC · On-site
$80 - $100/hr
Coordinate all aspects of the appeals process to ensure compliance with medical necessity criteria ... Analyze complex/non-routine member and provider appeals and grievances for all lines of business ...
New
Hopewell, NJ · On-site
$80 - $100/hr
About the Role This position is responsible for handling all Utilization Management medical appeal ... Evaluates care by problem solving, analyzing variances and participating in the quality improvement ...
Hopewell, NJ · On-site
$80 - $100/hr
About the Role This position is responsible for handling all Utilization Management medical appeal ... Evaluates care by problem solving, analyzing variances and participating in the quality improvement ...
Hopewell, NJ · On-site +1
About the Role This position is responsible for handling all Utilization Management medical appeal ... Evaluates care by problem solving, analyzing variances and participating in the quality improvement ...
Hopewell, NJ · On-site +1
About the Role This position is responsible for handling all Utilization Management medical appeal ... Evaluates care by problem solving, analyzing variances and participating in the quality improvement ...
$80 - $100/hr
Coordinate all aspects of the appeals process to ensure compliance with medical necessity criteria ... Analyze complex/non-routine member and provider appeals and grievances for all lines of business ...
New
$80 - $100/hr
Coordinate all aspects of the appeals process to ensure compliance with medical necessity criteria ... Analyze complex/non-routine member and provider appeals and grievances for all lines of business ...
New
Newark, NJ · On-site
$80 - $100/hr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
Newark, NJ · On-site
$80 - $100/hr
Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific ... Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of ...
Gibson City, IL · On-site
$60 - $80/hr
GENERAL SUMMARYThe PFS Medical Appeals Specialist is responsible for analyzing patient records, writing formal arguments, preparing, submitting and tracking insurance claims to maximize reimbursement ...
Gibson City, IL · On-site
$60 - $80/hr
GENERAL SUMMARYThe PFS Medical Appeals Specialist is responsible for analyzing patient records, writing formal arguments, preparing, submitting and tracking insurance claims to maximize reimbursement ...
Hopewell, NJ · On-site +1
About the Role This position is responsible for handling all Utilization Management medical appeal ... Evaluates care by problem solving, analyzing variances and participating in the quality improvement ...
Hopewell, NJ · On-site +1
About the Role This position is responsible for handling all Utilization Management medical appeal ... Evaluates care by problem solving, analyzing variances and participating in the quality improvement ...
$37K - $43.7K
23% of jobs
$44.7K is the 25th percentile. Wages below this are outliers.
$43.7K - $50.4K
12% of jobs
$50.4K - $57K
0% of jobs
$57K - $63.7K
3% of jobs
$63.7K - $70.4K
11% of jobs
The median wage is $71.8K / yr.
$70.4K - $77.1K
7% of jobs
$77.1K - $83.8K
17% of jobs
$84.8K is the 75th percentile. Wages above this are outliers.
$83.8K - $90.5K
15% of jobs
$90.5K - $97.1K
5% of jobs
$97.1K - $103.8K
0% of jobs
$103.8K - $110.5K
7% of jobs
$37K
$71.2K
$110.5K
Cities with the most Medical Appeal Analyst job openings:
States with the most job openings for Medical Appeal Analyst jobs include:
For Medical Appeal Analyst jobs, the most frequently searched job titles are:
Hopewell, NJ • On-site
$42 - $45/hr
Other
Posted 4 days ago
$42-$45 per hour
Hopewell, NJ
Contract
Duration: 3+ months contract with potential for FTE conversion
Job Description:
Responsibilities:
Prepares and presents appeals to Provider Appeals Committee in accordance with criteria including coordination with independent URO
Assesses patient's clinical need against established guidelines and standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay.
Evaluates the necessity, appropriateness and efficiency of medical services and procedures by inpatient facilities.
Performs review of medical records and prepares medical records for review by Medical Director as appropriate.
Documents accurately and comprehensively based on the standards of practice and current organization policies.
Interacts and communicates with facilities, physicians and or members/families, either telephonically and or on site striving for continuity and efficiency as the member is managed along the continuum of care.
Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
Education:
Licenses:
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring.
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US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
It services
1,001 - 5,000 Employees
Jersey City, NJ, US
2000
