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Medical Grievance and Appeals Nurse Salary
in Connecticut, United States

$93,327 (USD)

Average Salary

$45/hr

Average Hourly

$1,633

Average Bonus

Salary Recap

The average pay for a Medical Grievance and Appeals Nurse is $93,327 a year and $45 an hour in Connecticut, United States. The average salary range for a Medical Grievance and Appeals Nurse is between $65,131 and $116,022. This compensation analysis is based on salary survey data collected directly from employers and anonymous employees in Connecticut, United States.

Average Salary Chart

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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:
$108,192
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 Connecticut, United States

Registered Nurse (RN) Unit Manager
Sep 25
Plainfield, CT, USA
Colonial Health & Rehab Center of Plainfield LLC
Addresses any concerns, complaints, grievances the resident or their family may have. Ensures CNA ... Performs administrative duties such as completing medical forms, reports, evaluations, studies ...
Nurse Manager, Behavioral Health Inpatient
Nov 2
Vernon, United States
ECHN
... grievances. 6.##### Promotes staff satisfaction through a participative practice environment ... the Medical Staff. 13.# Demonstrates an ability to be flexible, organized and function under ...
Psychologist
Sep 12
Stonington, CT, USA
TeamHealth
... nursing and other Post-Acute Care facilities. TeamHealth provides medical and behavioral care to ... appeals of an outdoor adventurist. With Nipmuck State Forest nearby, it is a popular outdoor ...
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