Is anyone an appeals nurse? What is your day to day like? What is the pay like?

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I have been an appeals nurse since 2018. I simply review accounts day in and day out for medical necessity. Using criteria and evidenced based guidance. I am not on the phone and I don’t interact much with my co workers. It can get boring and repetitive. However, the job is very flexible and I make my own hours. No holidays or weekends. Actually the holidays are paid days off. I make $77k salary working from home.

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Sounds like it could be interesting, too. What is the process for gaining employment in this area of nursing?

Kindly,

Judy

Reviewing denials to see if we can uphold or maintain based on our criteria for our insurance policy. I did this in my last role with more of a case management background. Pay is 73-110k

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How did you get into being an appeals nurse??? Sounds like a great position for me!!! Have over 25 yrs experience in nursing.

I moved from research into cm/medical management doing UM, prior auth review and appeals reviews. Then I left that company and moved to a role just doing appeals reviews. I would say just keep applying to insurance companies.

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