Remote Manager, Appeals & Denials | CDI Leader

Clear Destination Inc.; Northern (KY); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Accuity Delivery Systems, LLC is seeking a Manager, Appeals & Denials to lead the inpatient DRG downgrades and appeals program. You will supervise staff, oversee audits, and ensure high-quality appeal letters for clients.

You will collaborate across CDI, Coding, DRG, and client health teams to ensure compliant, accurate documentation and effective denial management in a remote environment.

Qualifications

• Registered Nurse or degree in Healthcare Management, Healthcare Administration, Health Information Management, or another related field required.
• CCDS and/or CDIP certification or RHIA/RHIT certification preferred.
• Minimum of 5 years of appeals/denials or coding experience in the inpatient coding arena.
• Minimum of 5 years of management experience.
• Extensive knowledge of revenue cycle management and coding services.
• Extensive operational knowledge of both physician and hospital revenue cycle.
• Demonstrated knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and modifiers.
• Experience with electronic health records and health information systems.

Responsibilities

• Distributes the daily assignments to the department and monitors updates throughout the day.
• Reviews denials received from clients and applies appropriate knowledge to determine next steps.
• Determines whether denials are clinical or coding related and reviews the medical record to support appeal arguments.
• Tracks and trends denial data and prioritizes denials by due dates.
• Writes and supports the development of quality appeal letters for Accuity clients.
• Reviews No Appeal letters to determine appropriateness and provides feedback to Appeal Writers.
• Maintains integrity of data in Appeals & Denials tracking software.
• Ensures adequate staffing to support workload and assists teams as needed.
• Conducts regular audits to ensure quality and compliance.

Skills

Interpersonal skills

Customer service

Analytical skills

Leadership

Organizational skills

Prioritization

Education

RN or related healthcare degree

CCDS/CDIP or RHIA/RHIT preferred

Job description

Accuity Delivery Systems, LLC is seeking a Manager, Appeals & Denials to lead the inpatient DRG downgrades and appeals program. You will supervise staff, oversee audits, and ensure high-quality appeal letters for clients.

You will collaborate across CDI, Coding, DRG, and client health teams to ensure compliant, accurate documentation and effective denial management in a remote environment.