[Hiring] DRG Appeals Nurse @CorroHealth

Role Description

The DRG Appeals Specialist performs reviews of inpatient DRG payer denials on behalf of our hospital client partners. Responsibilities include:

• Reviewing denial letters, determination, and data entry of audit recommendations.
• Responsibility for professional and effective appeal responses that are submitted timely under payer timeframes.

Qualifications

• Current and valid RN license.
• DRG validation experience.
• Medical necessity experience and appeal letter writing.
• Coding certification (AHIMA or AAPC) is a plus.
• This is a remote position.

Requirements

• Active RN license in good standing required.
• CCS preferred after one year of employment (assistance is available for preparation).
• RHIT/RHIA/CPC is a plus.
• CDIP or CCDS is highly preferred.
• A minimum of 5 years of experience in any of the following roles:
• Inpatient coding quality assurance.
• DRG validation.
• DRG appeal.
• Clinical Documentation Integrity (CDI) as a Clinical Documentation Specialist (CDS), Educator, or Manager.

Benefits

• Enjoy work-life balance with a predictable schedule.
• Compensation includes salary plus bonus opportunities.
• Medical, Dental, Vision coverage, 401K.
• Holidays, paid time off, short term and long-term disability insurance, and life insurance.
• Reimbursement for continuing education and association dues.
• This is a remote position.