Reconsideration Analyst III

Job description

**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.** *This position is located Remote United States* Position Purpose: Makes second level non-medical appeal decisions. This may include review of appeal cases dismissed by the level 1 contractor or Expedited appeals. Essential Responsibilities: Writes a non-medical reconsideration decision that is clear and supports the determination Ensures that all appeal issues raised by the party (e.g., enrollee, representative, or non-contract provider) have been Provides a fair and impartial decision based on current evidence, regulations, policies, and Ensures all documents are releasable and do not violate any Privacy Act Organizes documents by dates of service relevant to the charges, research denials and regulations used and ensure that any overpayment calculation is correct. Mini...