Job Summary

A consulting firm is filling a position for a Remote Clinical DRG Appeals Review Nurse.

Core Responsibilities of this position include:

• Updating patient account record
• Developing recommendations to maintain efficient and effective processes
• Reviewing whether DRG' s are assigned correctly

Position Requirements Include:

• CCS Certification through AHIMA is required
• Registered Nurse (RN) License is required
• 2+ years of clinical appeals/denials writing experience
• 5+ years of clinical experience in Hospital inpatient and outpatient departments
• Experience reviewing and analyzing denied/downgraded MS-DRG and APR-DRG accounts received from payers