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RN Remote Grievance and Appeals

Manhattan, NY 10017

Posted: 10/02/2026 Employment Type: Contract Job Number: 29411426 Pay Rate: 55-60 USD/Hour

Job Description


Phaxis is looking for a dedicated Remote RN Grievance and Appeals Specialist in Manhattan, where your contributions will make a meaningful impact on patient care and overall clinic operations. We are looking for a reliable and detail-oriented individual who thrives in a dynamic environment.

Location - Fully Remote
Position - RN Grievance and Appeals Specialist
Schedule - Days, Monday through Friday
- 40 hours/week
- 20-week contract

Responsibilities
  • Review Clinical Records: Evaluate medical charts, prior authorizations, inpatient stays, and treatment histories against evidence-based guidelines like Milliman Care Guidelines (MCG) or InterQual.
  • Investigate Disputes: Examine why a service, procedure, or claim was reduced, terminated, or denied by an insurance payer or health system.
  • Collaborate with Medical Directors: Summarize clinical data and prepare case recommendations for physician consultants and medical directors to formally uphold or overturn an appeal.
  • Ensure Regulatory Compliance: Track strict state and federal timeframes (such as CMS or state Department of Health guidelines) to ensure decisions and response letters are legally compliant.
  • Act as a Liaison: Communicate appeal outcomes and medical rationales clearly to members, families, providers, legal teams, and external review boards (like State Fair Hearings or Independent Review Entities).
  • Track Quality Trends: Identify recurring claim denial patterns or quality-of-care issues and report them to clinical leadership for process improvements

Requirements
  • Medicare and Medicaid experience preferred
  • Strong backgrounds:
    • Utilization Management
    • Prior Authorization
    • Grievance & Appeals
    • Managed Care
  • G&A experience is preferred but not mandatory
  • Will need an NY RN License

*Temp (potential Perm)

 If you are passionate about providing exceptional patient care and want to be part of a supportive team, we would love to hear from you!

Meet Your Recruiter

Jon Silvidi

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About Manhattan, NY

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Drew Anson

Chief Delivery Officer

Drew Anson is Chief Delivery Officer at Phaxis, a Workforce Solutions Company based in New York.

In this role, Drew leads the delivery and recruiting working closely with the leadership team to define a model that is efficient at supporting the firm s current needs and is scalable for future growth.

Drew is a seasoned executive with more than 13 years of Services & Recruitment experience. In that time, he has supported numerous Fortune 100/500/1000 organizations across industries by providing global workforce solutions, namely resources and thought leadership for large-scale projects, implementations, and managed services.

Prior to joining Phaxis predecessor firm Park Hudson in 2021, Drew spent three years at engineering technology and talent solutions firm, Collabera, as Director of Sales in North Carolina. Earlier in his career, he spent nearly eight years at Insight Global, most recently as Sales Manager of the Columbus, OH office.

He holds a degree from Central Michigan University in Sales & Marketing.

Favorite Book: Extreme Ownership Jocko Willink & Leif Babin
Favorite Team: Michigan Wolverines
Inspirational Quote: There is no substitute for hard work. Thomas A. Edison