Remote Nurse: Appeals & Grievance Coordinator

Solü Technology Partners; Phoenix (AZ); On-site; USD 36,000 - 55,000; Part time

Benefits offered by this job

Remote work

Job summary

Solü Technology Partners is seeking a Med Appeals & Grievance Specialist Coordinator (Clinical) for a 5-month contract based in Phoenix, AZ. The role focuses on appeals, benefit determinations, and medical denials with a background in managed care or prior authorizations.

Must be a licensed nurse with strong clinical and analytical skills, capable of handling high volumes and coordinating with internal departments. Remote work is available; schedule 8:00–4:30 Mountain Time.

Qualifications

• Maintain confidentiality and privacy.
• Advanced clinical knowledge required.
• Interpersonal and active listening skills to ensure customer satisfaction.
• Ability to compose business correspondence and interpret policies.

Responsibilities

• Perform in-depth analysis, clinical review and resolution of provider appeals and denials across all lines of business.
• Identify, research, process, resolve and respond to customer inquiries through written and verbal communication.
• Analyze medical records and apply medical necessity criteria to determine appeal validity.
• Maintain complete and accurate records per department policy.
• Meet quality, quantity and timeliness standards per department guidelines.

Skills

Advanced clinical knowledge

Active listening

Data entry

Policy interpretation

Confidentiality

Team collaboration

Organizational skills

Communication

Education

Licensed Nurse (RN)

Tools

eviCore

MCG

InterQual criteria

Job description

Solü Technology Partners is seeking a Med Appeals & Grievance Specialist Coordinator (Clinical) for a 5-month contract based in Phoenix, AZ. The role focuses on appeals, benefit determinations, and medical denials with a background in managed care or prior authorizations.

Must be a licensed nurse with strong clinical and analytical skills, capable of handling high volumes and coordinating with internal departments. Remote work is available; schedule 8:00–4:30 Mountain Time.