Remote DRG Appeals RN | Clinically Driven Denials Specialist

CorroHealth, Inc.; United States; Remote; USD 80,000 - 110,000; Full time

Benefits offered by this job

Salary plus bonus opportunities

Medical, Dental, Vision coverage

401K

Holidays and paid time off

Disability and Life insurance

Continuing education reimbursement

Job summary

CorroHealth, Inc. is seeking an experienced DRG Appeals Specialist to review inpatient DRG payer denials for hospital partners. Responsibilities include reviewing denial letters, data entry of audit recommendations, and submitting timely appeal responses.

The ideal candidate holds an active RN license with DRG validation experience and medical necessity knowledge. Coding certifications (AHIMA or AAPC) are a plus. This is a remote position in the United States.

Qualifications

• Active RN license in good standing.
• DRG validation experience.
• Medical necessity experience and ability to write appeal letters.

Responsibilities

• Review inpatient medical records to validate Medicare, Commercial, and Third-Party DRGs.
• Verify ICD-10-CM/PCS codes, HAC/POA indicators, and discharge dispositions per guidelines.
• Prepare persuasive appeal letters with clinical evidence and clear rationale.
• Abstract denial findings into the proprietary system.
• Maintain expertise in coding guidelines and inpatient payment methods.
• Attend continuing education on coding integrity and compliance.

Skills

Inpatient Coding

DRG Validation

Medical Necessity

Appeals Letter Writing

ICD-10-CM/PCS Knowledge

Analytical Thinking

Regulatory Knowledge

Education

Active RN license

CCS certification (preferred)

RHIT/RHIA/CPC (plus)

CDIP or CCDS preferred

Tools

TruCode

3M Encoder and Grouper

Proprietary denial management app

Job description

CorroHealth, Inc. is seeking an experienced DRG Appeals Specialist to review inpatient DRG payer denials for hospital partners. Responsibilities include reviewing denial letters, data entry of audit recommendations, and submitting timely appeal responses.

The ideal candidate holds an active RN license with DRG validation experience and medical necessity knowledge. Coding certifications (AHIMA or AAPC) are a plus. This is a remote position in the United States.