Clinical Appeals Analyst
Remote
Job Id:
128591
Job Category:
Job Location:
Remote
Security Clearance:
None
Business Unit:
Piper Companies
Division:
Piper Clinical Solutions
Position Owner:
Katie Iverson
Piper Companies is currently seeking a Clinical Appeals Analyst for a remote opportunity within a highly accredited health insurance organization to complete the analysis, research, and completion of complex appeals.
Responsibilities of the Clinical Appeals Analyst:
- Assess, analyze, and complete non-routine appeals and grievance in order to ensure customer satisfaction
- Proper documentation through external sources such as pharmaceutical companies, health care providers, and attorneys
- Perform all work timely, and efficiently in compliance with mandated and legislative requirements
- Report to the Manager, Nurse Lead/ Team Leader, and Medical Lead
Qualifications of the Clinical Appeals Analyst:
- RN or LPN- North Carolina license
- 3 + years of inpatient care experience in the ER, med/surg, critical care, intensive care, or the step down unit
- Experience with EMR systems (electronic medical records)
- Adhere to mandated an legislative requirements by the NCDOI or the NCQA
Compensation for the Clinical Appeals Analyst:
- Annual Salary Range: $37-39/hr based on relative experience
- Comprehensive Benefits: Medical, Dental, Vision, 401k
Keywords: Clinical Appeals Analyst, health insurance, RN, LPN, NC, EMR, NCDOI, NCQA, pharmaceutical companies, health care, complex appeals, claims, analysis, research
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