Clinical Analyst

Job Title: Clinical Analyst

Job Location: Remote

Job Duration: Contract / FTE

Client: Federal

Criteria- Need US citizenship because of federal regulations and the sensitive nature of the work involved.

Ability to obtain Public Trust Clearance

Must-have skills

• US Healthcare / US Payer / Provider experience
• Utilization Management / Utilization Review / Prior Authorization
• Clinical or healthcare educational background
• ICD-10, CPT, HCPCS
• Claims, denials, billing or medical-necessity review
• Provider communication / provider calls
• Healthcare policy research and interpretation
• Case investigation / issue resolution
• Excel and reporting
• SOP/process documentation
• Strong written and verbal communication
• Able to work 8 AM–6 PM EST coverage

Originally posted on Himalayas