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Medicare Appeals Analyst Jobs (NOW HIRING)

Highmark Health

$80 - $100/hr

Identify and analyze operating deficiencies and work with other Medicare personnel to develop the ... experience Appeals experience Experience using claims process system (e.g. "MCS/FISS") Bachelor ...

Southcarolinablues

$80 - $100/hr

... appeal requests. Provides thorough clinical review or benefit analysis to determine if the ... Medicare Part B experience preferred * Strong computer proficiency, with the ability to navigate ...

New

Ourhrconnect

Analyst, Appeals

Carolina, RI · On-site +1

... appeal requests. Provides thorough clinical review or benefit analysis to determine if the ... Medicare Part B experience preferred * Strong computer proficiency, with the ability to navigate ...

Harbor Health

Appeals & Grievances Director

Austin, TX · On-site +1

Maintain deep working knowledge of CMS Medicare Advantage appeals and grievance regulations, TDI ... Analyze appeals and grievance trends to identify root causes and recommend process, policy, or ...

Stefanini Group

Appeals Intake Coordinator

Grand Rapids, MI · Hybrid

$21.25 - $26.25/hr

... member and provider Medicare appeals and grievances. This team member will screen incoming ... This team member will assign the incoming concern to the appropriate analyst and may assist in ...

Stefanini Group

Appeals Intake Coordinator

Grand Rapids, MI · Hybrid

$21.25 - $26.25/hr

... member and provider Medicare appeals and grievances. This team member will screen incoming ... This team member will assign the incoming concern to the appropriate analyst and may assist in ...

Wipro Limited

M&R Appeals Coder

Atlanta, NY · On-site

$24 - $25/hr

Review and analyze medical records for Medicare appeals. * Work on NCD/LCD denials, Duplicate denials, and MUE denials. * Compare medical findings to CMS guidelines. * Determine if conditions of ...

Wipro Limited

$25K - $50K/mo

Review and analyze medical records for Medicare appeals. * Work on NCD/LCD denials, Duplicate denials, and MUE denials. * Compare medical findings to CMS guidelines. * Determine if conditions of ...

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Medicare Appeals Analyst information

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$37K

$71.2K

$110.5K

How much do medicare appeals analyst jobs pay per year?

As of Sep 7, 2026, the average yearly pay for medicare appeals analyst in the United States is $71,216.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,000.00 and $87,000.00 per year, depending on experience, location, and employer.

What does a Medicare Appeals Analyst do?

A Medicare Appeals Analyst is responsible for reviewing, analyzing, and processing appeals related to Medicare claims that have been denied or disputed. They evaluate medical records, policy guidelines, and relevant regulations to determine if the denial was appropriate or if the claim should be overturned. Their work involves communicating with healthcare providers, patients, and insurance representatives to gather necessary documentation and ensure compliance with Medicare policies. The goal is to ensure that all appeals are resolved accurately and in a timely manner, while also maintaining adherence to federal and state regulations.

What are some common challenges Medicare Appeals Analysts face when reviewing cases, and how can they effectively manage them?

Medicare Appeals Analysts often encounter challenges such as interpreting complex medical records, staying current on frequently changing Medicare regulations, and managing high volumes of cases within tight deadlines. To effectively manage these challenges, analysts should develop strong organizational and analytical skills, maintain up-to-date knowledge through regular training, and utilize internal resources like decision-support tools and collaboration with clinical staff. Building a network with colleagues and maintaining open communication with providers can also help resolve ambiguities and ensure accurate, timely appeal determinations.

What are the key skills and qualifications needed to thrive as a Medicare Appeals Analyst, and why are they important?

To thrive as a Medicare Appeals Analyst, a solid understanding of healthcare regulations, Medicare policies, and claims processing is essential, often supported by a degree in healthcare administration or a related field. Familiarity with claims management systems, electronic health records (EHRs), and compliance software such as CMS portals is typically required. Analytical thinking, attention to detail, and effective communication help analysts review complex cases and collaborate with providers and government agencies. These skills ensure accurate appeals processing, minimize compliance risks, and support fair outcomes for patients and providers.
More about Medicare Appeals Analyst jobs

What states have the most Medicare Appeals Analyst jobs?

States with the most job openings for Medicare Appeals Analyst jobs include:

What job categories do people searching Medicare Appeals Analyst jobs look for?

The top searched job categories for Medicare Appeals Analyst jobs are:

Medicare Appeals Analyst jobs near you
Infographic showing various Medicare Appeals Analyst job openings in the United States as of August 2026, with employment types broken down into 89% Full Time, 6% Part Time, and 5% Contract. Highlights an 82% Physical, 7% Hybrid, and 11% Remote job distribution, with an average salary of $71,216 per year, or $34.2 per hour.

Appeals Intake Coordinator (Medicare Appeals & Grievances) â Remote

A-Line Staffing Solutions

Grand Rapids, MI • Remote

$22 - $28/hr

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Title: Appeals Intake Coordinator (Medicare Appeals & Grievances) – Remote Location: Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) Schedule: Full-Time | Monday–Friday (standard business hours) Pay: $22.00–$28.00/hr Summary Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) Hiring an Appeals Intake Coordinator for a fully remote role focused on Medicare appeals and grievances intake. This Appeals Intake Coordinator will review incoming member and provider complaints, screen for urgency and type of issue, and route cases to the appropriate analyst for resolution. Ideal for candidates with managed care experience who are detail-driven, fast in a queue environment, and strong in written documentation and professional correspondence.

Responsibilities

Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) Review, screen, and triage incoming Medicare appeals and grievances based on urgency and concern type Assign complaints/appeals to the correct analyst and maintain accurate intake documentation Support investigations by gathering documentation, tracking items, and assisting with correspondence as needed Communicate with members, providers, and regulatory entities regarding actions, decisions, and required information Partner with internal teams (Customer Service, Utilization Management, clinical leadership) to coordinate next steps Participate in quality monitoring, auditing, and workflow improvement activities Maintain strict HIPAA compliance and accurate handling of protected health information (PHI) Work independently while meeting productivity, accuracy, and turnaround expectations in a high-volume environment Qualifications Remote (Michigan-based preferred; aligned to Grand Rapids, MI 49525) High School Diploma or GED (required) 1+ year experience in health insurance / managed care performing Appeals & Grievances functions (required) Strong written communication, organization, and time management skills Ability to prioritize quickly and stay accurate in changing, fast-paced queues Proficiency with Microsoft Office (Outlook, Word, Excel) Preferred: exposure to HealthEdge, Epic, and/or Facets Comfortable working remotely with consistent attendance and high attention to detail

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About A-Line Staffing Solutions

Sourced by ZipRecruiter

A-Line Staffing Solutions is an established full-service recruiting and staffing provider that operates in the industry of human resources and recruitment. Based in Utica, Michigan, A-Line Staffing Solutions has been committed to its mission of providing innovative and effective workforce solutions since its foundation. The company specializes in providing high-quality staffing solutions for a range of disciplines, including Information Technology, Professional, Administrative, Healthcare, and more. A-Line prides itself on its ability to offer comprehensive and tailored staffing solutions in line with the varying needs of different businesses, which has played a crucial role in the company's growth and success.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Utica, MI, US

Year founded

2004

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