Remote DRG Nurse Reviewer & Appeals Specialist
$95k - $110kGainwell Technologies
Gainwell Technologies is seeking a DRG Nurse Reviewer Appeals and Hearings professional for remote work. You will coordinate and perform appeal duties, analyze documentation, prepare case files and participate in hearings, both virtual and on-site as needed. Required are an active US RN license, CPC/CCS/CPMA certification, and 5+ years of clinical or coding experience. Expect remote work with up to 25% travel for onsite hearings and a salary range of $95,000-$110,000. #J-18808-Ljbffr
$95k - $110k
...Select how often (in days) to receive an alert: DRG Nurse Reviewer Appeals and Hearings- Remote Date: Aug 30, 2026 Location: Any city, FL, US, 99999 Work... ...Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA...Remote workFull timeWork from homeRelocation packageFlexible hours- Gainwell Technologies is seeking a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform all appeal related duties including analyzing... ...files and case summaries for hearings. The role offers remote (work from home) options with up to 25% travel for onsite hearings...Remote jobWork from home
- CorroHealth is seeking a DRG Appeals Specialist to perform reviews of inpatient DRG payer denials for hospital clients. You will validate ICD-10-CM/PCS... ...coding guidelines to maximize appropriate reimbursements. This is a remote position. #J-18808-Ljbffr CorroHealth IncRemote job
- ...expanded its product offering to include DRG Revenue Integrity services.... ...positively change healthcare! This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES... ...Member. Job Description: The DRG Appeals Specialist performs reviews of inpatient DRG payer denials on...Remote workTemporary workWork at officeLocal areaImmediate startShift work
$29.7 - $31.8 per hour
...experience The Acute Coding Appeals Specialist integrates medical coding... ...is responsible for reviewing and writing appeals for inpatient... ...inpatient Diagnosis Related Group, (DRG) denials in order to support... .... ~ This is a remote position; however, candidates...Remote workTemporary workWork at officeLocal area- Hartford HealthCare in Connecticut seeks a Level 2 Denial Specialist Appeal Writer to review DRG downgrades, interpret medical records per ICD-10-CM/PCS guidelines, and craft persuasive appeal letters to optimize reimbursement. You will educate CDI teams and department...
- Hartford HealthCare is seeking a Level 2 Denial Specialist Appeals Writer within our System Support Office to review DRG downgrades and craft persuasive appeal letters. This role requires nursing expertise, ICD-10-CM/PCS knowledge, and strong communication to educate CDI...Work at office
- ...a dynamic Inpatient Coder for the Appeals department to analyze third party coding... ...draft detailed appeal letters, and review denial trends. The role involves DRG validation, interpreting payer... ...reimbursements. You will collaborate with nurse auditors and patient services while...
- ...assigned levels of denials by submitting appeal letters and required documentation to insurance... ...filing time limits. Submit external review requests and required documentation to... ...patient to get the denial overturned. Remote: Although this position is listed as remote...Remote work
- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
$19.5 - $21 per hour
...are seeking a detail-oriented and experienced Appeals Specialist for our client in Middleburg Heights, Ohio. In... ...Monday-Friday 8am-5pm ~3 months in office then remote ~ Benefits offered Key Responsibilities Review assigned insurance denials and EOBs to...Remote workWork at officeImmediate startMonday to Friday$21.16 - $38.37 per hour
...Join to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina Healthcare . This position is remote and will be working Pacific Standard hours.... ...and grievance outcomes. Requests and reviews medical records, notes, and/or detailed...Remote workHourly payFull timeContract workWork experience placementWork at office- UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a... ...business hours Monday through Friday. In this role, you will review clinical documentation within the medical record to ensure that...Remote jobWork from homeMonday to Friday
- ...healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and... ...case resolutions. This is a 100% remote role requiring an RN, LPN, or... ...practice and knowledge of Utilization Review Guidelines. The position offers a competitive...Remote work
- ...Clinical Documentation Integrity Consultant to join our team in a remote, hybrid-capable role. You will engage with hospital clients and... ...in inpatient settings, with CCDS/CDIP preferred, and strong MS-DRG/APR-DRG knowledge. Travel to client sites (10-15%) is required where...Remote job
- Guardant Health seeks a Reimbursement Specialist II, Follow-Up and Appeals to join the revenue cycle team. You will analyze EOBs, appeal denials, and manage payer communications, all while supporting patient financial services and process improvements. Responsibilities...Remote job
- ...ensuring adherence to official coding guidelines and client guidelines. This role supports DRG outcomes with CC/MCC consideration and requires abstracting data elements during chart reviews. The position offers telecommuting within the United States, a competitive benefits...Remote job
- UnitedHealthcare offers a remote-friendly physician assistant role across the United States, focusing on review and adjudication of appeals and grievances. You will collaborate with medical directors and an integrated team to assess medical necessity and benefit design....Remote jobWeekday work
$21.16 - $38.37 per hour
A healthcare provider is seeking a Medicare Appeals & Grievances Specialist to handle member appeals and grievances. This remote position requires strong experience in managed care, particularly with Medicare regulations. Ideal candidates will have excellent attention...Remote jobHourly payWork at office- Mass General Brigham Health Plan is seeking an Appeals Coordinator to coordinate, process, investigate, and document member appeals across... ...collaboration, and ensuring regulatory compliance in a remote environment within the United States. Ideal candidates will have...Remote job
- ...medicine diagnostics, is seeking an Insurance Reimbursement Specialist to maximize collections by pursuing unpaid claims and managing multi-level appeals. This full-time role is based in Brisbane, CA, with some remote collaboration for eligible candidates. You will work...Remote jobFull time
- Sacbar is seeking an experienced Inpatient Hospital Coder - Denial Appeals Specialist in Towson, MD to review and write compelling appeals for DRG-related denials. The role requires strong inpatient coding knowledge, MS-DRG assignment, clinical documentation, payer policies...
- ...WCBO) is seeking an Inpatient Coder for the Appeals department. The role analyzes third party... ...audits, drafts detailed appeal letters, and reviews clinical level of care to identify denial trends. Responsibilities include DRG validation, reviewing audit letters, and providing...
- Elevance Health is seeking a Nurse Reviewer I to perform preauthorization and medical necessity reviews for diagnostic imaging. The role is remote with required in-person training sessions and potential location-based adjustments. Strong emphasis on collaboration with providers...Remote job
- ...a Clinical Documentation Specialist (CDS) to join their remote team. The ideal candidate... ...strong understanding of MS-DRG coding concepts, and the ability... ...concurrent medical record reviews and collaboration with... ...degree or be a Registered Nurse with CCDS or CCDIP...Remote jobFull time
$50k
...authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. The Appeals Specialist I is responsible for performing triage,... ...atmosphere of frequent interruptions Remote Work Requirements ~ High speed internet (10...Remote workFull timeContract workWork experience placement- ...Dallas, TX is seeking a Coding/CDI Denials Analyst to review inpatient coding denials for accuracy and to ensure... ...aligns with Official Coding Guidelines and DRG assignments. The role includes composing appeals, identifying trends for root causes of denials, and...Remote job
- ...experienced Inpatient Reimbursement Coding Specialist to join Health Information Management.... ...to inpatient accounts, ensuring accurate DRG/APR-DRG assignment and documentation alignment... ...certs and 1 year experience required; remote work options available. #J-18808-Ljbffr...Remote job
- Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and... ...documentation principles in medical record reviews, supporting high-quality recoveries and... ...and internal teams. The role offers hybrid/remote work with required in-person training....Remote job
- ...Services is seeking a Care Manager RN for a remote, full-time role. The position involves... ...focuses on coordinating clinically-based appeals and reimbursement processes for patients... ...Candidate must have an Associate's Degree in Nursing, CA RN license, and at least four years...Remote jobFull timeDay shift
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