Appeals Nurse Specialist Salary in United States

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Average Salary for Appeals Nurse Specialist in United States

The average salary of a(n) Appeals Nurse Specialist in United States is $68,652.

The average hourly rate of a(n) Appeals Nurse Specialist in United States is $33.01.

The average bonus of a(n) Appeals Nurse Specialist in United States is $1,044.00.

Job Description:

Investigates and researches time-sensitive appeals cases regarding medical health needs, patient care issues, transportation, medications, durable medical equipment, or home care by using medical investigative skills. Maintains liaison with enrollees in a health plan and providers, pharmacies, and other medical entities involved in the appeals process. Organizes cases to ensure timely completion and to avoid fines or penalties that may be imposed. Requires RN or LVN license. Researches, investigates, and resolves issues identified in correspondence. Reviews contract language and medical record documentation from contracted providers, non-contracted providers, and outside entities. Serves as contact person with enrollees and providers during the investigation of appeals. Documents and summarizes the investigation's result. May prepare appeal correspondence. Less

Investigates and researches time-sensitive appeals cases regarding medical health needs, patient care issues, transportation, medications, durable medical equipment, or home care by using medical investigative skills. Maintains liaison with enrollees in a health plan and providers, pharmacies, and other medical... More

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Results for Appeals Nurse Specialist in United States

Nurse Specialist - Utilization Management - Cleveland, OH

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Registered Nurse with current license to practice in the State of Ohio. Experience in communication with Insurance companies for authorization or appeals in an...

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Advanced Practice Nurse - Avon, IN

Cummins Behavioral Health Systems

Must possess Indiana state licensure as a Registered Nurse with certification as a Clinical Nurse Specialist or Nurse Practitioner with prescriptive authority....

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Clinical Appeals Specialist - Providence, RI

Lifespan

The Clinical Appeals Specialist reports to the Manager Appeals. Is responsible for review of medical records to ascertain appeal information and for the...

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Grievance and Appeal Specialist - Manhattan, NY

VISITING NURSE SERVICE OF NEW YORK

Resolves grievances, appeals and external reviews for VNSNY CHOICE product lines ’t; Develops correspondence communicating the outcome of grievances and appeals...

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Inquiry Dispute/Appeals Specialist - Troy, MI

Molina Healthcare

Inquiry Dispute/Appeals Specialist. Assesses level of determination and/or appeal. Maintain well-organized, accurate and complete files for all appeals....

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