Clinical Analyst

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🔥 2 minutes ago

🦀 Maryland – Remote

🦀 Maryland – Remote

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Global Alliant Inc

WebsiteLinkedInAll Job Openings

51 - 200 employees

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

Global Alliant Inc. is an award-winning information technology consulting and software development company based in Maryland. With expertise in AI, machine learning, and cloud solutions, they empower federal and state agencies to tackle complex challenges efficiently. Their services include agile practices, DevSecOps, data analytics, and AI-driven digital transformation. They have a proven track record in enhancing efficiency and security for government agencies through innovative IT solutions, exemplified by projects such as improving NOAA's data processing and automating HRSA's workload. Their focus on agile methodologies and security integration supports consistent, impactful results.

📋 Description

• Analyze clinical and healthcare-related cases • Perform utilization management, utilization review, and prior authorization reviews • Review claims, denials, billing, and medical necessity • Communicate with providers and conduct provider calls • Research and interpret healthcare policies • Investigate cases and resolve issues • Prepare Excel reports • Document and maintain SOPs and processes • Provide coverage from 8 AM–6 PM EST

🎯 Requirements

• US citizenship required due to federal regulations and sensitive work • Ability to obtain Public Trust Clearance • US healthcare, US payer, or provider experience • Experience with utilization management, utilization review, or prior authorization • Clinical or healthcare educational background • Knowledge of ICD-10, CPT, and HCPCS • Experience with claims, denials, billing, or medical-necessity review • Provider communication and provider calls • Healthcare policy research and interpretation • Case investigation and issue resolution • Excel and reporting • SOP/process documentation • Strong written and verbal communication • Ability to work 8 AM–6 PM EST coverage