State Licensed Senior Clinical Appeals RN
A company is looking for a Senior Clinical Appeals RN who will utilize expertise in MS-DRG and APR-DRG auditing to manage appeals and provide guidance to clinical teams. Key Responsibilities: Analyze and resolve DRG Appeals and respond to various appeal levels Review medical records and collaborate with auditors to provide insights and recommendations Research and prepare written appeals while navigating online tools and resources Required Qualifications: Associates Degree (or higher) Unrestricted RN license in the state of residence 3+ years of MS DRG/APR DRG coding experience in a hospital environment Advanced proficiency with ICD-10-CM and ICD-10-PCS coding Ability to obtain CCS or CIC certification within 6 months of hire
