Reconsideration Analyst I (Part C)

**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**

*This position is located Remote United States*

*This position requires working weekends, and rotating holidays as needed *

*Please note the start date is on or after July 6, 2026*

Position Purpose:

Serves as a support person for the reconsideration professionals and physician reviewers for second level reconsiderations resolutions.

Essential Responsibilities:

• Coordinates the delivery of appeals case files resolution documents and reconsideration decisions from and to the external entities.
• Builds a reconsideration case file from evidence submitted or auto-forwarded from Plans and analyzes each case to ensure it meets the requirements for a valid reconsideration as mandated by Centers for Medicare and Medicaid Services (CMS) or other customer entities.
• Analyzes and makes decisions based on medical vs. non-medical case type, appeal/review categories, validity of appeal.
• Inputs appropriate data regarding reconsiderations into the applicable required systems.
• Responds to reconsideration from appellants//providers.

Minimum Qualifications

Education

• High School Diploma or equivalent

Experience

• One (1) year of general office experience
  • College education or technical training in administration, business, or related areas may be substituted for experience on a year per year basis. (Education requirements may be satisfied by full-time education or the prorated part-time equivalent.)
• Medicare Part C related appeals activities, preferred
• Resided in the United States for a minimum of three (3) years out of the last five (5) years (Per Contract Requirement)

Benefits

C2C offers an excellent benefits package, including:

• Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
• Section 125 plan
• 401K
• Competitive salary
• License/credentials reimbursement
• Tuition Reimbursement

EOE Vet/Disability