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
