Clinical Analyst

Job Description and Tasks:

Candidates will have to manage their workload, perform under pressure, and work well with the rest of the team.

  • Quickly and efficiently review medical records and submit well-written appeals to health insurers and governmental payers.
  • Be comfortable, skilled, assertive, cordial, and professional on the telephone to follow up on submitted appeals.
  • Navigate through various computer systems and applications to find information about insurance claims.
  • Apply clinical standards to determine appropriate level of care
  • Provide feedback to colleagues and clients in a constructive, positive, friendly, and affirming manner

Required Qualifications:

  • Either a BS in Nursing OR an MD
  • GPA of 3.0 or higher
  • Proficiency in Microsoft Office, including Word and Excel
  • Highly attentive to detail
  • Excellent organizational and time management skills
  • Clear, concise, and logical writing style
  • Exemplary people skills

Preferred Qualifications:

  • Prior experience in a clinical setting (e.g. hospital, doctor’s office, outpatient facility)
  • Familiarity with clinical standards (e.g. Milliman Care Guidelines, InterQual Criteria)