ZipRecruiter

Log In

1

Reconsideration Analyst Jobs (NOW HIRING)

LEIBOVIC LAW GROUP LLP

Attorney

Chatsworth, CA

$42 - $92/hr

... application, reconsideration and hearing level to determine merit and legal theory of the case ... analytical skills and abilities Ability to prioritize multiple projects Knowledge of the 5-step ...

next page

Showing results 1-20

People also search for

All JobsReconsideration Analyst Jobs

Reconsideration Analyst information

See salary details

$29.5K

$71.5K

$123K

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.
More about Reconsideration Analyst jobs
What are the most commonly searched types of Reconsideration Analyst jobs? The most popular types of Reconsideration Analyst jobs are:
What job categories do people searching Reconsideration Analyst jobs look for? The top searched job categories for Reconsideration Analyst jobs are:
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.

Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)

Ohio Department of Taxation

Columbus, OH

Full-time

Posted 15 days ago

Job description

What You Will Do At ODM:

Office: Legal Counsel

Bureau: Program Integrity

Classification: Medicaid Health Systems Administrator 1 RN (PN: 20092018)

Job Overview:

The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). SURS is charged with helping the agency review utilization of Medicaid services, detect fraud, waste and abuse and recover inappropriate payments to providers. As a Clinical Review Nurse Supervisor your responsibilities will include:

  • Helping to manage an over $ 7million/ year hospital utilization contract
  • Reviewing necessary medical record reviews and making a determination on hospital appeals.
  • Supervising and training RNs, Auditors, and Analysts in identifying fraud, waste, and abuse in the Medicaid program.
  • Participating/leading meetings with external stakeholders including law enforcement
  • Developing and implementing changes to processes and procedures as needed in a team environment
  • Evaluating provider clinical compliance with state and federal Program Integrity rules
  • Evaluating provider medical documentation and billing practices for fraud, waste and abuse
  • Recovering overpayments for medically unnecessary services via administrative procedures and/or referrals to health oversight agencies
  • Responding to provider clinical reconsideration (appeal) requests
  • Consulting on clinical matters with ODM policy units and other state agencies
  • Coordinating clinical Program Integrity efforts with ODM contractors and managed care plans
  • Presenting findings from clinical reviews of provider non-compliance
  • Responding to inquiries from the public, consumers, providers, and other agencies

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis); Current & valid license as registered nurse as issued by Ohio Board of Nursing, pursuant to Sections 4723.03-4723.09 of Ohio Revised Code;

Or 12 months experience as Medicaid Health Systems Specialist, 65293, may be substituted for the experience required, but not for the mandated licensure.

Note: education & experience is to be commensurate with approved position description on file.

-Or equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure.
 

Technical Skills: Nursing

Professional Skills: Collaboration, Confidentiality, Continuous Improvement, Innovation, Verbal Communication, Written Communication

Apply