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The graph below is a comparison of salary data for 10 jobs in Knoxville, Tennessee, as provided by the free SalaryExpert® Salary Report and Salary Calculator. If you are a professional who requires compensation survey data for your work please consult ERI Economic Research Institute's Salary Assessor.

Medical Claims Review Nurse:
Resolves, audits, and processes claims for clinically related issues to ensure accuracy of claims payment, supporting the Claims Administration Department. Maintains contact with community hospitals and providers, reviewing, processing, and auditing claims for payment and appropriateness of charges and pursues... [+] More

Medical Claims Review Nurse:
Resolves, audits, and processes claims for clinically related issues to ensure accuracy of claims payment, supporting the Claims Administration Department. Maintains contact with community hospitals and providers, reviewing, processing, and auditing claims for payment and appropriateness of charges and pursues adjustments as warranted. Typically requires licensure as a Registered Nurse and at least one year of experience in utilization review or a managed care setting.

Screens, audits, and processes claims of specific criteria for appropriate payment. Establishes effective ongoing relationships with community hospitals and providers. Participates in educational, provider relations, and contracting meetings with providers to address medical claims payment issues. Visits the providers as necessary to compare billed charges to the medical record. Provides support to the Accounting Department in determining financial liability for out-of-plan medical services. Performs special projects, reconciliations, research, and analysis relating to the utilization and cost of medical services. Works closely with various departments to coordinate the flow of information involving payment of medical bills and analyses of financial liability. Ensures compliance with contractual obligations on claims payments. Documents findings and writes follow-up reports. Recommends and implements innovative strategies to retain members, contain medical costs, and improve efficiency. (Source: eDOT Job Description) [-] Less

A renter's cost of living for someone making $64,373 in Knoxville, Tennessee is 86.5% of the US National Average. For more information, or to compare cost of living data between two cities, click here.

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Utilization Review Director, Utilization Review Manager, Utilization Review/Quality Assurance Director, Utilization Review Supervisor, Utilization Review Coordinator, Medical Claims Review Manager, Utilization Review/Quality Assurance Coordinator, Banking Loan Review Analyst, Analyst Loan Review, Loan Review Analyst, Correspondence Review Clerk, Insurance Review Clerk, Medical Emergency Room Nurse, Medical Gerontology Nurse, Medical Head Nurse, Medical Home Care Nurse, Medical Infection Control Nurse, Medical Intensive Care Unit Nurse, Medical Licensed Practical Nurse, Medical Midwife Nurse, Medical Nurse Anesthetist, Medical Nurse Consultant, Medical Nurse Practitioner, Medical Nursing Aide, Medical Nursing Home Director, Medical Nursing Instructor, Medical Nursing Manager, Medical Nursing Shift Supervisor, Medical Nursing Supervisor, Medical Obstetrics/Gynocology Nurse, Medical Occupational Nurse, Medical Office Nurse, Medical Oncology Nurse, Medical Operating Room Nurse, Medical Private Duty Nurse, Medical Psychiatric Nurse, Medical Public Health Nurse, Medical School Nurse, Claims Adjudicator Medical

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