Clinical DRG Denial Specialist - Riedman - Remote, Health Information Management (Full-Time, Days)

Job Overview:

• Apply clinical and coding expertise to manage DRG denials and protect reimbursement.
• Strengthen revenue integrity through pre-bill documentation and coding review.

Core Responsibilities:

• Ensure timely resolution of DRG-related payer denials and audits.
• Produce well-supported appeal outcomes using clinical, coding, and payer policy knowledge.
• Improve denial prevention strategies by analyzing payer trends and appeal outcomes.

Qualifications and Skills:

• Requires an Associate's degree in Health Information Management and NYS RN licensure.
• Preferred certifications include RHIT, RHIA, or CCS, and experience with Epic and encoding software.