rn med appeals & grievance specialist coordinator
Posted 1 day ago by Randstand (USA)
Negotiable
Outside
Remote
aguila, arizona (remote)
Summary: The RN Med Appeals & Grievance Specialist Coordinator role at a top healthcare company involves remote work focused on the analysis and resolution of provider appeals, member appeals, and grievances. Candidates must possess a current RN license in Arizona or a Compact RN license. The position requires in-depth clinical review and problem-solving skills. This role is classified as outside IR35.
Key Responsibilities:
- Perform in-depth analysis, clinical review, and resolution of provider appeals/inquiries, corrected claims, and subscriber reconsiderations.
- Handle member appeals, corrected claims, and provider grievances for all lines of business.
- Identify, research, process, resolve, and respond to various appeals and grievances.
Key Skills:
- Current RN License in Arizona or a Compact RN license.
- Strong analytical and clinical review skills.
- Experience in handling appeals and grievances in a healthcare setting.
Salary (Rate): £25.90 hourly
City: Aguila
Country: United States
Working Arrangements: remote
IR35 Status: outside IR35
Seniority Level: undetermined
Industry: Other
Top Healthcare Company is hiring an RN to work remotely as a Med Appeals & Grievance Specialist Coordinator! ***Must have a current RN License in Arizona or a Compact RN license***
Duties:
- Perform in-depth analysis, clinical review and resolution of provider appeals/inquiries, corrected claims and subscriber reconsiderations, member appeals, corrected claims and provider grievances for all lines of business
- Identify, research, process, resolve and respond to various appeals and grievances.