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