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Appeals and Grievance Specialist RN Salary
in Arizona, United States

$79,032 (USD)

Average Salary

$38/hr

Average Hourly

$1,383

Average Bonus

Salary Recap

The average pay for an Appeals and Grievance Specialist RN is $79,032 a year and $38 an hour in Arizona, United States. The average salary range for an Appeals and Grievance Specialist RN is between $55,155 and $98,250. This compensation analysis is based on salary survey data collected directly from employers and anonymous employees in Arizona, United States.

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Job Summary

Description:
  • Evaluates and resolves clinical appeals, grievances, and external reviews received from members or providers, including review of pre-service and post-service appeals, utilizing understanding of clinical department operations and claims processing procedures.
  • Communicates and interacts with external partners, including providers, medical groups, Independent Practice Associations, and other external vendors.
  • Reviews medical records related to grievances and appeals, provides monitoring of cases involving medical decisions and quality or care or service, and prepares and performs clinical reviews.
  • Logs grievances and appeals; obtains medical records as needed; and provides clinical reviews, write-ups, and recommendations.
  • Develops correspondence communicating acknowledgement and resolution to enrollees and providers, following appeal time frames.
  • Requires RN license.

Salary Potential

Estimated salary in 2024:
$91,620
5 Year Change:
16 %

Education

Education data not available for this job

Skills

Skills data not available for this job

Appeals and Grievance Specialist RN Job Listings for Arizona, United States

Registered Nurse-Medical Appeals/Grievance Specialist - Job #4182
Jan 14
Phoenix, AZ, USA
Blue Cross Blue Shield of Arizona
... appeals, grievances, reconsiderations and corrected claims for all lines of business with emphasis ... a Registered Nurse (RN) Required Job Skills * Intermediate PC proficiency (All Levels
Medical Appeals/Grievances RN
Jan 11
Phoenix, AZ, USA
Healthcare Support
Medical Appeals/Grievances RN Are you an experienced Medical Appeals/Grievances RN looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career ...
Operating Room Registered Nurse
Jan 16
Tucson, AZ, USA
Travel Nurses, Inc.
Communicate with collaborating physicians or specialists regarding patient care * Educate patients ... Active, unencumbered, AZ state RN license or Compact License * 2 references you have worked with in ...
RN Corrections - 13 Week Contract
Jan 10
Florence, AZ, USA
Maxim Healthcare Services
When necessary, the Corrections Registered Nurse (RN) makes referrals of inmates to the staff physician, nurse practitioner, dentist, mental health professional, or specialist in alcohol and drug ...
Registered Nurse (RN) Team Lead - Central AZ
Dec 31
Central, AZ, USA
APN Staffing & Employment Solutions
Refer any unresolved patient grievances to Director of Nursing to be addressed. Document all ... Registered Nurse (R.N.) with valid, Arizona State license * ADN, AAS degree required * One year of ...
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