Grievance and Appeals Nurse Salary in Delaware, United States
The average pay for a Grievance and Appeals Nurse is $87,136 a year and $42 an hour in Delaware, United States.
The average salary range for a Grievance and Appeals Nurse is between $60,811 and $108,325.
This compensation analysis is based on salary survey data collected directly from employers and anonymous employees in Delaware, United States.
Average Salary Chart
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.
Estimated salary in 2023:
5 Year Change:
Education data not available for this job
Skills data not available for this job
Grievance and Appeals Nurse Job Listings for Delaware, United States