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Reconsideration Analyst Jobs (NOW HIRING)

TMF Health Quality Institute

Team Lead

Austin, TX · On-site +1

Serves as a lead staff member and subject matter expert for Appeals Specialists, Clerks, Dispute Resolution Analyst, Intake Specialists, LEP Analysts, and/or Reconsideration Analyst. * Uses subject ...

Reliant

OR · On-site

Draft second level reconsideration letters * Assist with drafting and responding to state disputes ... Strong analytical abilities * Strong computer skills and experience with relevant software

Avalon Healthcare Solutions

Business Claims Associate

Tampa, FL · On-site

$16.75 - $22.75/hr

... analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and ... Responsibilities of the Claims Associate includes the submittal of weekly Provider Reconsideration ...

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How much do reconsideration analyst jobs pay per year?

As of Jun 1, 2026, the average yearly pay for reconsideration analyst in the United States is $71,511.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,500.00 and $79,000.00 per year, depending on experience, location, and employer.

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

To thrive as a Reconsideration Analyst, you need strong analytical abilities, attention to detail, and knowledge of relevant regulations, often supported by a background in healthcare, insurance, or claims processing. Familiarity with claims management systems, case tracking software, and possibly certifications in medical coding or claims adjudication is usually required. Excellent communication, problem-solving, and organizational skills help you effectively review appeals and interact with stakeholders. These skills are crucial for ensuring accurate, timely, and fair resolution of reconsideration requests, ultimately supporting compliance and customer satisfaction.

What are some common challenges faced by Reconsideration Analysts when reviewing appeals, and how can they effectively address them?

Reconsideration Analysts often encounter challenges such as incomplete documentation, tight deadlines, and navigating complex regulations while reviewing appeals. To address these, it's important to maintain strong organizational skills, communicate clearly with both internal teams and claimants, and stay updated on relevant policies and procedures. Collaborating closely with other departments, such as medical review or legal teams, can also help ensure thorough and accurate assessments. Proactively seeking clarification and maintaining attention to detail are key strategies for success in this role.

What are Reconsideration Analysts?

Reconsideration Analysts are professionals who review and evaluate appeals or requests for reconsideration of decisions, often within insurance, healthcare, or government agencies. Their main responsibility is to assess cases where a claim, application, or request was initially denied, ensuring all relevant information and regulations are considered before making a new determination. They communicate with claimants, gather additional documentation if needed, and provide a thorough and unbiased review of each case. Reconsideration Analysts play a crucial role in ensuring fairness and compliance in the decision-making process.
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Reconsideration Analyst jobs near you
Infographic showing various Reconsideration Analyst job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $71,511 per year, or $34.4 per hour.
Reconsideration Analyst II

Reconsideration Analyst II

TMF Health Quality Institute

Austin, TX • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 26 days ago

Job description

**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**
*This position is located Remote United States*
Position Purpose:
Conducts second level non-medical Medicare appeals decisions , including review of appeal cases dismissed by the level 1 contractor.
Essential Responsibilities:
  • Writes a non-medical reconsideration decision that is clear and supports the determination made.
  • Ensures that all appeal issues raised by the party (e.g., enrollee, representative, ornon-contract provider) have been addressed.
  • Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures.
  • Ensures all documents are releasable and do not violate any Privacy Act provisions.
  • Organizes documents by dates of service relevant to the charges, research denials and regulations used by the contract and ensure that any overpayment calculation made is correct.
  • Conducts research using online federal regulations, Medicare policy, standards of medical practice, contractor manuals, coverage issues manuals, and other related resources to complete accurate and well-supported decision.

Minimum Qualifications
Education
  • High School Diploma or equivalent

Experience
  • Two (2) years of general office experience
    • College education or technical training in administration, business, or related areas may be substituted for experience on a year per year basis. (Education requirements may be satisfied by full-time education or the prorated part-time equivalent.)
  • One (1) year of Medicare appeals or Managed Care appeals
  • Experience directly relevant to Medicare managed care appeals or utilization management activities, preferred

Benefits
C2C offers an excellent benefits package, including:
  • Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
  • Section 125 plan
  • 401K
  • Competitive salary
  • License/credentials reimbursement
  • Tuition Reimbursement

EOE Vet/Disability
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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