Remote
•
4d ago
Title: Clinical Nurse Specialist REQUIRED: ACTIVE RN LICENSE (multi-state preferred) Key Responsibilities: Perform clinical coding and DRG validation for various service types. Review claims for accuracy and severity of stay based on appropriate diagnosis codes. Apply CMS guidelines, state policies, and payer requirements in coding processes. Support appeals and reconsiderations, including Medicaid-related cases. Collaborate with vendors and internal teams on coding and editing systems. Ensure
Easy Apply
Contract, Third Party
Depends on Experience