Healthcare Appeals Analyst

If you’re passionate about healthcare, compliance, and making a real impact on member experience, this remote Appeals Analyst role offers the opportunity to apply your analytical skills in a highly regulated, mission-driven environment. You’ll play a critical role in ensuring fair, accurate, and timely resolution of appeals, grievances, and coding disputes—supporting both members and providers while upholding regulatory excellence. Location : Remote Pay Rate : $28-33/hr Schedule: M-F, 8am-5pm Employment Type : temporary with potential pathway for hire Why This Role Matters This role is essential to ensuring members and providers receive accurate, compliant, and well-supported determinations. Your work directly impacts regulatory compliance, member trust, and organizational integrity while supporting continuity of healthcare services. What You’ll Do Analyze, research, resolve, and respond to confidential appeals, coding disputes, grievances, and coverage/organizational determinations in accordance with regulatory and accreditation guidelines Interpret and clearly explain health plan benefits, policies, procedures, medical terminology, and coding to members and providers Exercise independent judgment to make sound decisions aligned with organizational policies and guidelines Prepare comprehensive case files and position statements for external reviews, including independent review organizations, benefit panels, and external medical consultants Draft thorough, compliant responses that clearly support determinations made Document investigations, findings, and actions across all required systems Monitor daily reports to ensure timeliness and service-level compliance Gather and evaluate clinical information using established medical policies and criteria, partnering with Medical Directors on clinical appeals and grievances Ensure all work meets state and federal regulatory requirements, accreditation standards, and internal performance guarantees What We’re Looking For A current, up-to-date resume Bachelor’s degree or advanced degree where required 3 years of related experience (or 5 years of related experience in lieu of a degree) Ability to analyze complex information and apply policies with sound judgment Strong written communication skills for drafting detailed, compliant responses Willingness to obtain Certified Professional Coder (CPC) credential within 1 year if supporting coding disputes Ability to meet compliance requirements What’s In It For You Fully remote schedule (Monday–Friday, 8am-5pm) Opportunity to work in a highly regulated, impactful healthcare environment Exposure to complex appeals, regulatory standards, and cross-functional collaboration Professional growth within healthcare operations and compliance Benefits for Manpower Associates (Upon Eligibility) Medical, dental, disability, and life insurance 401(k) retirement plan Employee Assistance Program Referral bonuses And more! ManpowerGroup is committed to providing equal employment opportunities in a professional, high quality work environment. It is the policy of ManpowerGroup and all of its subsidiaries to recruit, train, promote, transfer, pay and take all employment actions without regard to an employee's race, color, national origin, ancestry, sex, sexual orientation, gender identity, genetic information, religion, age, disability, protected veteran status, or any other basis protected by applicable law. #J-18808-Ljbffr ManpowerGroup