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Nurse Grievance and Appeals Salary
in Arizona, United States

$79,032 (USD)

Average Salary

$38/hr

Average Hourly

$1,383

Average Bonus

Salary Recap

The average pay for a Nurse Grievance and Appeals is $79,032 a year and $38 an hour in Arizona, United States. The average salary range for a Nurse Grievance and Appeals 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

Nurse Grievance and Appeals 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 ... 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 ...
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