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Appeals and Grievance Specialist RN Salary
in Connecticut, United States

$93,486 (USD)

Average Salary

$45/hr

Average Hourly

$1,636

Average Bonus

Salary Recap

The average pay for an Appeals and Grievance Specialist RN is $93,486 a year and $45 an hour in Connecticut, United States. The average salary range for an Appeals and Grievance Specialist RN is between $65,242 and $116,219. This compensation analysis is based on salary survey data collected directly from employers and anonymous employees in Connecticut, 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 2023:
$108,377
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 Connecticut, United States

Operating Room Nurse (OR RN)
Dec 7
Greenwich, CT, USA
TAL Healthcare
Required Skills for Operating Room Registered Nurse: · Current CT RN license required; · NY RN ... Chain specialists - Nurse Managers - Nurse Practitioners - Revenue enhancers - Practice ...
Immediate Hiring for Registered Nurse Supervisor in Connecticut!
Dec 12
Stamford, CT, USA
Priority Care Staffing
Priority Care Staffing is looking for RNS in Stamford, Connecticut! Benefits: (after 3 mos ... Kimberly Doblado Recruitment Specialist Priority Care Staffing 1441 Broadway, 6th Floor Suite 6019 ...
RN - Registered Nurse
Nov 30
Manchester, CT, USA
Evergreen Endoscopy Center, LLC
Registered Nurse sought for South Windsor Outpatient Endoscopy Center. Assist physicians during ... Communicate with collaborating physicians or specialists regarding patient care * Educate patients ...
RN - Registered Nurse
Nov 30
Hartford, CT, USA
Evergreen Endoscopy Center, LLC
Registered Nurse sought for South Windsor Outpatient Endoscopy Center. Assist physicians during ... Communicate with collaborating physicians or specialists regarding patient care * Educate patients ...
RN - Registered Nurse
Nov 30
South Windsor, CT, USA
Evergreen Endoscopy Center, LLC
Registered Nurse sought for South Windsor Outpatient Endoscopy Center. Assist physicians during ... Communicate with collaborating physicians or specialists regarding patient care * Educate patients ...
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