Health Insurance Appeals Analyst

Looking for a meaningful role where your investigative skills, healthcare knowledge, and ability to manage competing priorities can make a real impact? Join a leading health insurance organization as an Appeals Analyst, where you'll play a key role in researching and resolving complex member and provider concerns while ensuring compliance with regulatory requirements.

Location: Remote*
Pay Rate: $30.00 - 33.00/hour
Employment Type: Contingent with potential pathway to hire
Schedule: Monday-Friday, 8:00 AM-5:00 PM

Why This Role Matters

As an Appeals Analyst, you will help ensure members and providers receive timely, accurate, and compliant resolutions to appeals, grievances, and coverage determinations. Your work directly supports quality service, regulatory compliance, and positive member experiences.

What You'll Do

• Analyze, research, investigate, and resolve appeals, grievances, coding disputes, and coverage determinations
• Review and interpret health plan benefits, policies, procedures, medical terminology, and coding information
• Prioritize and manage a high-volume caseload while meeting strict regulatory deadlines
• Communicate with providers, members, and internal teams to gather information and resolve issues
• Prepare grievance response letters and position statements for external reviews
• Document investigations, findings, and actions within required systems
• Monitor daily work queues and reports to ensure timeliness and compliance standards are met
• Partner with Medical Directors and internal stakeholders to support clinical appeal reviews

What We're Looking For

• A current, up-to-date resume
• Bachelor's degree and 3 years of related experience, or 5 years of related experience in lieu of a degree
• Medicare experience
• Health insurance industry experience
• Strong time management and workload prioritization skills
• Ability to research, analyze, and resolve complex issues independently
• Appeals, grievances, or claims experience preferred
• Coding experience preferred
• Ability to meet compliance requirements

What's In It For You

• Fully remote work opportunity with a respected healthcare organization
• Competitive pay rate of $30-$33 per hour
• Opportunity to develop expertise in Medicare, appeals, and grievance operations
• Exposure to regulatory and compliance-driven healthcare processes
• Potential pathway to long-term employment
• Collaborative team environment supporting professional growth

Benefits for Manpower Associates (Upon Eligibility)

Upon completion of waiting period associates are eligible for:

• Medical and Prescription Drug Plans
• Dental Plan
• Supplemental Life Insurance
• Short Term Disability Insurance
• 401(k)

Remote Eligibility: Remote workers must reside in one of the following states to be eligible for this remote opportunity: North Carolina, Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, Wyoming.