Remote Clinical Coding Appeals Nurse - Competitive Bonus

Santa Barbara Cottage Hospital; United States; Remote; USD 65,000 - 117,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records and draft appeals for denied and underpaid claims. The role focuses on accurate coding using ICD-9/10, CPT, HCPCS, and NCCI guidance, and requires inpatient experience and coding certifications.

This remote, independent position offers a target bonus and competitive pay. Applicants should have a Nursing degree, 5 years inpatient clinical experience, and an active RN license is preferred.

Qualifications

• Bachelor's Degree in Nursing is required.
• 5 years of inpatient clinical experience.
• Certification: CCS (AHIMA) or CPC (AAPC).
• Active RN license preferred; LPN with acute inpatient experience considered.

Responsibilities

• Review and interpret medical records to appeal denied and underpaid claims.
• Apply clinical judgment for DRG downgrades from Clinical Validation Reviews.
• Draft appeal letters using ICD-9/10-CM/PCS, CPT, HCPCS, and NCCI guidance.
• Ensure timely completion of all appeals to meet deadlines.

Skills

Nursing

Inpatient experience

CCS

RN license

MS Office

Education

Bachelor's in Nursing

Tools

MS Office Suite

Job description

R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records and draft appeals for denied and underpaid claims. The role focuses on accurate coding using ICD-9/10, CPT, HCPCS, and NCCI guidance, and requires inpatient experience and coding certifications.

This remote, independent position offers a target bonus and competitive pay. Applicants should have a Nursing degree, 5 years inpatient clinical experience, and an active RN license is preferred.