RN DRG Appeals Reviewer
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Remote Registered Nurse DRG Appeals Reviewer (CCS or CIC) We’re looking for a Registered Nurse to join a respected organization consistently recognized as a certified great workplace, known for its strong sense of purpose , inclusive culture , and commitment to employee growth . This full-time, remote role is ideal for individuals who are detail-oriented, thrive in coding/auditing environments, and want to grow within a specialized payment integrity team.
Schedule & Location:
- Fully remote (any U.S. time zone)
- Monday – Friday, 8:00 AM – 5:00 PM CST
- Review previously denied inpatient claims to confirm the denial was appropriate
- Re-evaluate DRG assignment, coding, and clinical documentation
- Complete detailed appeals reviews when providers dispute the denial
- Use clinical validation guidelines to determine if the original DRG/payment should stand or be adjusted
- Support the clinical review team with high-level claim analysis
- 100% Remote!
- Medical (HDHP) with pharmacy, dental, and vision coverage
- Health Savings Account (HSA) with employer contribution and FSA options
- 100% coverage for imaging, therapy, DME, and home health
- Employee Assistance Program (EAP)
- 401(k) with employer contribution potential
- Basic Life & AD&D, Core LTD, and Buy-Up LTD
- Voluntary Life & AD&D
- Voluntary Accident, Critical Illness, Hospital Indemnity, and Whole Life insurance options
- Active, clear RN license in state of residence
- 2 years recent DRG coding/validation experience
- Ability to review denials and defend findings with documentation
- CIC or CCS required
- Call: 407-636-5712
- Email: Brandon.schabbel@healthcaresupport.com