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 $68,810.

The average hourly rate of a(n) Appeals Nurse Specialist in United States is $33.08.

The average bonus of a(n) Appeals Nurse Specialist in United States is $1,046.00.

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

Clinical Denial/Appeals Specialist - Carson City, NV

Carson Tahoe Regional Healthcare

Registered nurse (RN) licensure preferred. Under the direction of the Manager of PFS, The clinical denial appeals specialist is responsible for the...

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Denials and Appeals Specialist - Brentwood, TN

Diversicare Management Services

Denials and Appeals Specialist. LPN, Licensed Practical Nurse. Assist in maintaining an electronic tracking system for all adrs, denials, and appeals....

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RN Appeals Specialist - Frisco, TX

AmerisourceBergen

RN Appeals Specialist. Draft appeal letters for HCP review (using client provided/approved appeal. To develop sound and well-supported appeal arguments, where...

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TRICARE Senior RN Accreditation Specialist - Telecommute - Phoenix, AZ

UnitedHealth Group

Telecommute, work from home, RN, Registered Nurse, Nurse, Accreditation, Accreditation survey, standards,Clinical Quality Management, quality, CPHQ, Data...

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Clinical Appeals Specialist - Case Management - 8hr Per Diem / Relief Day - Santa Rosa, CA

Santa Rosa Memorial Hospital

Clinical Appeals Specialist. Is to coordinate and execute the appeal process for clinical appeals and third party audits....

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