Job Description

Pre-Employment Requirements:

• We are a drug free facility. Passing a pre-employment drug screening is required

Education/Experience Requirements:

• Current RN License, BSN preferred.
• Minimum of 2 years of experience with clinical validation denials, DRG downgrade denials, and appeal writing.
• Strong understanding of ICD-10 coding guidelines and clinical documentation standards.
• Knowledge of payer audit processes, RACs, commercial payer reviews, and denial rationale interpretation.
• Excellent written communication and clinical documentation analysis skills.
• Strong critical thinking and attention to detail.
• Proficiency with electronic medical records and Microsoft Office applications.