Senior Clinical Appeals RN - Bridgeport Connecticut

Company: VirtualVocations
Location: Bridgeport, Connecticut
Posted On: 11/17/2024

A company is looking for a Senior Clinical Appeals RN to review and respond to appeals related to DRG coding and reimbursement.



Key Responsibilities

Analyze and respond to DRG appeals at various levels
Review medical records and collaborate with auditors to determine overpayment or claim adjustments
Prepare written appeals and provide coaching to DRG Validation Specialists



Required Qualifications

Associates Degree or higher
Unrestricted RN license in the state of residence
3+ years of MS DRG/APR DRG coding experience in a hospital environment
Intermediate knowledge of ICD-10-CM and ICD-10-PCS coding
CCS or CIC certification or willingness to obtain within 6 months of hire More...

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