Clinical Appeals Analyst

1 month ago


Remote, Oregon, United States Piper Companies Full time

Piper Companies is currently seeking a Clinical Appeals Analyst for a remote opportunity within a highly accredited health insurance organization to complete the analysis, research, and completion of complex appeals.

Responsibilities of the Clinical Appeals Analyst:

  • Assess, analyze, and complete non-routine appeals and grievance in order to ensure customer satisfaction
  • Proper documentation through external sources such as pharmaceutical companies, health care providers, and attorneys
  • Perform all work timely, and efficiently in compliance with mandated and legislative requirements
  • Report to the Manager, Nurse Lead/ Team Leader, and Medical Lead

Qualifications of the Clinical Appeals Analyst:

  • RN or LPN- North Carolina license
  • 3 + years of inpatient care experience in the ER, med/surg, critical care, intensive care, or the step down unit
  • Experience with EMR systems (electronic medical records)
  • Adhere to mandated an legislative requirements by the NCDOI or the NCQA

Compensation for the Clinical Appeals Analyst:

  • Annual Salary Range: $37-39/hr based on relative experience
  • Comprehensive Benefits: Medical, Dental, Vision, 401k

Keywords: Clinical Appeals Analyst, health insurance, RN, LPN, NC, EMR, NCDOI, NCQA, pharmaceutical companies, health care, complex appeals, claims, analysis, research



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