Remote Clinical Coding Appeals Nurse

R1-Rc; United States; Remote; USD 65,000 - 117,000; Full time

Job summary

R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records and draft appeals of denied or underpaid claims. You will apply clinical judgment to DRG downgrades and prepare persuasive letters using ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance.

This remote, production-driven role requires nursing qualifications, CCS or CPC certification, inpatient experience, and proficiency with MS Office tools.

Qualifications

• Bachelor's Degree in Nursing is required.
• 5 years of inpatient clinical experience.
• Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
• Active Registered Nurse is strongly preferred.

Responsibilities

• Review medical records to appeal denied/underpaid claims.
• Apply clinical judgment for DRG downgrades after reviews.
• Draft persuasive appeal letters using ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance.

Skills

MS Office

Adobe

Excel

Education

Bachelor's Degree in Nursing

Tools

MS Office

Adobe

Excel

Job description

R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records and draft appeals of denied or underpaid claims. You will apply clinical judgment to DRG downgrades and prepare persuasive letters using ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance.

This remote, production-driven role requires nursing qualifications, CCS or CPC certification, inpatient experience, and proficiency with MS Office tools.