Onsite RN DRG Appeals Specialist

CorroHealth Inc; Wellington (IN); Presencial; USD 70 000 - 95 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical coverage

Dental coverage

Vision coverage

401K & PTO

Resumo da oferta

CorroHealth Inc. in Indianapolis is seeking a DRG Appeals Specialist who will review inpatient DRG payer denials on behalf of hospital client partners.

The role requires validating ICD-10-CM/PCS codes, discharge dispositions, HAC/POA indicators, and crafting professional appeal letters. The ideal candidate holds an active RN license with DRG validation experience, medical necessity knowledge, and coding credentials (AHIMA or AAPC).

Qualificações

• Active RN license required.
• DRG validation experience required.
• Coding certification (AHIMA or AAPC) is a plus.

Responsabilidades

• Review inpatient medical records to validate DRG assignments for Medicare, Commercial, and Third-Party claims.
• Validate ICD-10-CM/PCS codes, discharge dispositions, HAC/POA indicators and ensure compliance with coding guidelines.
• Craft professional appeal letters with strong clinical evidence and arguments.
• Enter audit findings into the proprietary application and maintain up-to-date documentation.

Conhecimentos

Inpatient coding

DRG validation

Critical thinking

Regulatory knowledge

Formação académica

Active RN license

CCS preferred

RHIT/RHIA/CPC a plus

Ferramentas

3M Encoder

TruCode

Denials app

Descrição da oferta de emprego

CorroHealth Inc. in Indianapolis is seeking a DRG Appeals Specialist who will review inpatient DRG payer denials on behalf of hospital client partners.

The role requires validating ICD-10-CM/PCS codes, discharge dispositions, HAC/POA indicators, and crafting professional appeal letters. The ideal candidate holds an active RN license with DRG validation experience, medical necessity knowledge, and coding credentials (AHIMA or AAPC).