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Clinical Coding Appeals Nurse
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- As our Clinical Coding Appeals Nurse , you will help review and interpret medical records to draft appeals of denied and underpaid claims.
- Then you will draft appeal letters based on clinical judgment and knowledge and make coding change suggestions to our clients based on ICD-9/10 CM & PCS, CPT, HCPCS, and NCCI guidance.
- To thrive 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.
- 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 third-party auditor.
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