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Medical Grievance and Appeals Nurse Salary
in Arizona, United States

$79,023 (USD)

Average Salary

$38/hr

Average Hourly

$1,383

Average Bonus

Salary Recap

The average pay for a Medical Grievance and Appeals Nurse is $79,023 a year and $38 an hour in Arizona, United States. The average salary range for a Medical Grievance and Appeals Nurse is between $55,149 and $98,239. 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:
$91,610
5 Year Change:
16 %

Education

Education data not available for this job

Skills

Skills data not available for this job

Medical Grievance and Appeals Nurse 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
... and/or Medical Appeals and Grievance (MAG) Preferred Job Skills * Advanced PC proficiency ... Associate's Degree in a healthcare field of study or Nursing Diploma Required Licenses * Active ...
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 ...
Register Nurse-Inpatient
Dec 27
Tucson, AZ, USA
Mohave mental health clinic
AEB direct observation, Patient Grievance Report, Incident/ Accident/ Death Reports, Individual ... medical staffs. POSITION REQUISITES: Qualifications and Experience : * Current and valid Arizona ...
Register Nurse-Inpatient
Dec 27
Phoenix, AZ, USA
Mohave mental health clinic
AEB direct observation, Patient Grievance Report, Incident/ Accident/ Death Reports, Individual ... medical staffs. POSITION REQUISITES: Qualifications and Experience : * Current and valid Arizona ...
Assistant Director of Nursing ADON
Dec 31
Phoenix, AZ, USA
Corizon Health, Inc.
Functions as a senior clinical nurse for respective area of responsibility. Supervises the delivery ... Answers patient grievances in a timely and complete manner and assists the Charge Nurses with ...
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