Arizona Licensed Grievance Nurse
Job Summary
To support a prominent healthcare client, the fully remote Arizona Licensed Grievance Nurse will review and process Medicare grievances and appeals, investigate claims, and ensure compliance with CMS regulations while working full-time, 40 hours per week.
Key responsibilities
- Review and process standard and expedited Medicare grievances and appeals
- Investigate member, provider, and customer-service appeal issues
- Ensure cases are completed within required CMS timelines and maintain knowledge of CMS regulations
Required qualifications
- Current, active, unrestricted RN or LPN license in Arizona or an eligible Compact Nursing Multistate License
- 5+ years of experience with CMS member services, grievances, and appeals
- Strong understanding of Medicare and CMS requirements
- Experience reviewing medical records and health plan benefit documentation
- Associate's degree in a healthcare-related field or Nursing Diploma
Complete Job Description
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