New Jersey Licensed Medical Policy Analyst

A company is looking for a Medical Policy Analyst responsible for medical policy determination and analysis of claims. Key Responsibilities Provide timely and accurate responses to inquiries from claim policy teams regarding medical reviews and appeals Prepare cases for Medical Director and outside consultant review as necessary Identify opportunities for policy development or revisions based on case reviews and manage assigned inventory Required Qualifications High School Diploma/GED required; Bachelor's degree preferred or relevant experience in lieu of degree Minimum of 2 years clinical experience and 3 years in the health care delivery system/industry Active Unrestricted RN License required; NJ License preferred Prefer Certified Professional Coder credentials