Remote Coding Appeals Nurse — ICD-10/DRG Expert

R1 RCM Holdco Inc.; Georgia; Hybrid; 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, draft appeals of denied and underpaid claims, and ensure accurate coding of DRG revisions using ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance.

This is a remote, independent, production-driven role requiring RN with 5 years of inpatient experience and CCS or CPC certification; LPNs may be considered based on experience. Base pay ranges $65,000–$116,747.20 per year, with a target 10% annual bonus.

Qualifications

• Bachelor's Degree in Nursing required.
• 5 years of inpatient clinical experience required.
• Active RN license preferred; CCS or CPC certification preferred.

Responsibilities

• Review medical records to appeal denied and underpaid claims.
• Apply clinical judgment for DRG downgrades from reviews.
• Draft appeal letters using ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance.
• Ensure appeals meet internal and external deadlines.

Skills

Inpatient clinical experience

RN license (active)

CCS or CPC certification

MS Office proficiency

Education

Bachelor's Degree in Nursing

Tools

Adobe

Excel

Job description

R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records, draft appeals of denied and underpaid claims, and ensure accurate coding of DRG revisions using ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance.

This is a remote, independent, production-driven role requiring RN with 5 years of inpatient experience and CCS or CPC certification; LPNs may be considered based on experience. Base pay ranges $65,000–$116,747.20 per year, with a target 10% annual bonus.