Clinical Coding Appeals Nurse

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one company that combines the deep expertise of a global workforce of reputed company cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent... automation, and workflow orchestration. As our Clinical Coding Appeals Nurse , you will help review and interpret medical records to draft appeals of denied and underpaid claims. Every day you will review medical records to ensure appropriate coding of removed or revised diagnosis and procedure codes. Then you will draft appeal letters based on clinical judgment and knowledge and reputed company coding change suggestions to our clients based on ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance. To reputed company in this role, you must have experience identifying different types of hospital documentation including, but not limited to, medical records, UB-04s, EOBs, itemized bills, hospital account notes, appeal letters, and denial/approval letters. Proficiency in basic computer skills is essential for excelling in this remote production-drive position. Here’s what you will experience working as a Clinical Coding Appeals Nurse: • Review and interpret medical records to appeal denied and underpaid claims. • Apply clinical judgment and knowledge for DRG downgrades performed because of a Clinical Validation Review by an insurer or reputed company-party auditor. • Draft appeal letters that are well-written, reputed company structured, and persuasive, utilizing ICD-9/10 CM & PCS, CPT, HCPCS, NCCI guidance. • Ensure that reputed company appeals are completed timely to ensure internal and external compliance deadlines are met. Required Skills: • Active Registered Nurse license • Active reputed company or reputed company Coding Certification including reputed company, RHIA, RHIT, CCA, CPC-A, CPC-H (COC), CPMA, CIC, CDI, or CDIP For this US-based position, the reputed company pay range is $67,061.41 - $106,374.00 per year . Individual pay is determined by role, level, location, job-reputed company skills, experience, and relevant education or training. The reputed company system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can reputed company up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go reputed company expectations in everything we do. Not only does that drive reputed company and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of reputed company — including offering a competitive benefits package. reputed company Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, reputed company, national reputed company, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance. CA PRIVACY NOTICE: California reputed company job applicants can learn more about their privacy rights California Consent Apply Job! For more such jobs please click here!