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 $68,741.

The average hourly rate of a(n) Appeals Nurse Specialist in United States is $33.05.

The average bonus of a(n) Appeals Nurse Specialist in United States is $1,045.00.

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

Sr. Appeals Nurse Specialist - Baltimore, MD

Johns Hopkins Hospital/Johns Hopkins Health System

Appeals Nurse Specialist performs activities to ensure appropriate financial remuneration for inpatient services from third party payers....

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Reg. Nurse - Appeals/Denials Specialist II - Troy, MI

Molina Healthcare

Active, unrestricted State Licensed Register Nurse, Vocational Nurse or Licensed Practical Nurse in good standing....

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Appeals & Grievance Nurse Specialist - Los Angeles, CA

L.A. Care Health Plan

The Grievance & Appeals Nurse Specialist provides direct assistance to member's with health care access or benefit coordination issues, ensuring that clinical...

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Telephonic Nurse Advocate, RN - Sugar Land / Houston, TX - Houston, TX

UnitedHealth Group

Call Center Nurse, RN, Nurse Advocate, Registered Nurse, Call Center, Bilingual, Sugar Land, TX, Houston, TX, Texas....

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Nurse Specialist - Utilization Management - Cleveland, OH

University Hospitals

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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