How much does an Appeal Resolution Nurse make in the United States? The average Appeal Resolution Nurse salary in the United States is $83,036 as of April 26, 2022, but the range typically falls between $76,788 and $90,951. Salary ranges can vary widely depending on many important factors, including education, certifications, additional skills, the number of years you have spent in your profession. With more online, real-time compensation data than any other website, Salary.com helps you determine your exact pay target. View the Cost of Living in Major Cities
Conducts the medical review activities needed to resolve and process clinical appeals and claims. Reviews applicable medical records and assesses clinical data to investigate and resolve disputes over the medical necessity for services, approvals, pre-certifications, or other cases. Understands and interprets applicable medical terminology, clinical procedures, regulations and policies. Documents cases according to guidelines and standard procedures. Prepares the documentation required for further medical review, hearings, and different appeal processes. Typically requires a bachelor's degree in nursing or equivalent. Requires a Registered Nurse (RN) license. Typically reports to a manager. Work is generally independent and collaborative in nature. Contributes to moderately complex aspects of a project. Typically requires 4 -7 years of related experience. (Copyright 2022 Salary.com)
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Includes base and annual incentives
4 - 7 years experience
3 + years experience
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