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Global Alliant Inc

Clinical Analyst

Posted 20 days ago
2-5 years experience
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AI Summary

The Clinical Analyst will perform medical-necessity reviews, manage prior authorizations, and handle claims or denials. They are also responsible for healthcare policy interpretation, case investigation, and maintaining detailed process documentation.

Job Title: 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

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