State Licensed Senior Clinical Appeals RNVirtualVocations • Santa Clara, California, United States
State Licensed Senior Clinical Appeals RN
VirtualVocations • Santa Clara, California, United States
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A company is looking for a Senior Clinical Appeals RN.
Key Responsibilities
Analyze and respond to DRG appeals, including complex conceptual analyses
Review medical records and collaborate with auditors to determine overpayment or claim adjustments
Prepare written appeals and provide coaching to remote DRG Validation Specialists
Required Qualifications
Associate's degree (or higher)
Unrestricted RN license in the state of residence
3+ years of MS DRG / APR DRG coding experience in a hospital environment
Advanced proficiency with ICD-10-CM and ICD-10-PCS coding
CCS or CIC certification or ability to obtain within 6 months of hire
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Licensed Clinical • Santa Clara, California, United States
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