Clinical Analyst

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) #J-18808-Ljbffr