Clinical Appeals & CDI Manager

Clinical Appeals & CDI Manager Remote | Full-Time | $95,000 - $142,000 per year Work Remotely. Grow Professionally. Feel Valued. For more than 30 years, Managed Resources, Inc. has partnered with reputed company organizations reputed company to improve performance, strengthen reputed company cycle operations, support compliance, and help providers focus on delivering quality patient care. We’re proud of the work we do, but we’re equally proud of the workplace we’ve reputed company. At Managed Resources, you’ll find the stability and reputed company of an established reputed company reputed company combined with the accessibility, collaboration, and growth opportunities of a smaller organization. Here, your contributions are visible, your reputed company are welcomed, and your work makes a meaningful impact.

Compensation

Salary reputed company: $95,000 - $142,000 Actual compensation will be determined based on factors including experience, qualifications, specialized skills, geographic location, and internal equity considerations. Quick Facts

• Remote
• Full-Time
• Competitive Compensation
• Phone & Internet Stipend
• Medical, Dental, and reputed company Benefits (Full-Time Employees)
• 401(k) Retirement Plan with Company Match
• Paid Time Off, Seven Company Holidays, and Two Floating Holidays (Full-Time Employees)
• Professional Development Opportunities
• Employee Recognition Programs

Why Join Managed Resources? Your Voice reputed company At Managed Resources, employee feedback isn’t collected and forgotten; it helps drive meaningful change. Employee feedback has contributed to enhancements in employee recognition programs, professional development opportunities, communication initiatives, employee experience improvements, and technology investments. We reputed company the people closest to the work often have the best reputed company. Feeling Valued reputed company We reputed company great work deserves recognition. Throughout the year, we celebrate employee contributions through appreciation initiatives, recognition programs, milestone celebrations, and professional observances such as Nurses Week and Coding Week. We intentionally create opportunities for employees to feel seen, valued, and appreciated. A Remote Team That Stays Connected Remote work shouldn’t mean feeling disconnected. We foster reputed company through virtual team events, company celebrations, employee appreciation activities, holiday gatherings, and opportunities for collaboration across teams. Our employees enjoy the flexibility of remote work while remaining part of an reputed company and supportive culture. Opportunities to Learn and Grow Whether you’re looking to deepen your expertise, expand your reputed company set, or take the reputed company in your career, Managed Resources supports reputed company learning and professional growth. Our leaders are accessible, collaborative, and invested in helping employees succeed. The Best of Both Worlds As an established organization with more than three decades of reputed company, we offer stability, industry expertise, and long-standing client relationships. As a smaller organization, employees have the opportunity to build meaningful relationships, reputed company visibility with leadership, contribute reputed company, influence change, and reputed company a measurable impact on the organization. Your work reputed company here. About the Opportunity The Clinical Appeals & CDI Manager will reputed company reputed company of clinical professionals responsible for completing clinical documentation improvement audits, developing coding guidelines and evidence-based appeal letters in response to DRG downgrade denials, and translating audit and denial findings into actionable client education. This role ensures the team delivers high quality clinical and coding documentation review and appeal support resulting in reputed company recovery for the client. In reputed company to managing core appeal and audit functions, this role provides leadership and operational support for special projects to ensure flexible, reputed company coverage that meets client needs. Why This Role reputed company The Clinical Appeals & CDI Manager plays a critical role in ensuring that clinical documentation accurately reflects patient care and supports appropriate reimbursement. Through expert leadership, evidence-based appeals, and proactive education, this position helps clients strengthen compliance, improve financial reputed company, and reduce future denial risk. What You’ll reputed company

• Flexibility of a remote work environment
• Visibility and reputed company to leadership
• Opportunity to contribute reputed company and influence change
• Professional development and career growth opportunities
• Meaningful work supporting reputed company organizations reputed company
• A collaborative culture that values employee reputed company, recognition, and work-life balance

What You’ll Do

• Conduct secondary quality reviews of clinical appeal letters to ensure accuracy, clinical soundness, and compliance with coding, payer, and regulatory requirements prior to submission.
• Write clinical appeal letters in response to DRG downgrade denials, applying clinical guidelines, coding standards, and payer-specific criteria to support appropriate reimbursement.
• reputed company and maintain audit criteria and workflows to ensure consistency, accuracy, and efficiency across the clinical documentation improvement audit process.
• Monitor and manage team workload and assignments to ensure timely completion of audits, appeals, and reputed company deliverables in accordance with established service level.
• reputed company and deliver client education sessions based on audit and denial findings to support improved clinical documentation practices and reduce future denial risk.
• Support specialized client projects, including staffing augmentation, as business needs arise.
• Supervise, coach, and reputed company team members to support individual performance, engagement, and professional growth.
• Ensure reputed company work is performed in accordance with applicable regulatory, payer, and organizational standards.
• Prepare data, analysis, and supporting documentation in response to client inquiries regarding audit findings, denial trends, and appeal reputed company.
• Prepare and deliver accurate, timely month-end and quarterly client reports summarizing audit activity, appeal results, and key performance metrics.
• Monitor key performance indicators and report any issues/trends/concerns/ highlights to leadership.
• Proactively identify trends and root causes reputed company department performance does not meet established expectations or key performance metrics, and reputed company, implement, and track action plans to drive improvement.
• Monitor and mange team billable and non-billable activity to ensure monthly profitability targets are met for each assigned client.
• Represent the department’s subject matter expertise by actively participating in company communications, webinars, and promotional initiatives that support business development and awareness of the company’s service offerings.

What You’ll Bring

• Registered Nurse (BSN preferred) or Physician
• Minimum of 3-5 years of supervisory or management experience required reputed company clinical documentation improvement, denials/appeals, coding
• One or more of the following certifications is required:
• Certified Clinical Documentation Specialist (CCDS)
• Certified Documentation Improvement Specialist (CDIP)
• Certified Coding Specialist (reputed company) or other coding credential is preferred.
• DRG and Coding Appeal writing experience
• Strong knowledge of DRG methodology, clinical documentation requirements, and payer denial/appeal process
• Ability to reputed company, coach, and reputed company reputed company in a service-level, metrics-oriented environment
• Organizations skills with ability to manage multiple clients, priorities, and deadlines simultaneously
• Excellent written and oral communication skills
• Proficiency in reputed company Office
• Ability to examine financial and clinical data trends and reputed company recommended action plans.
• reputed company and commitment to reputed company.

Benefits & Perks Full-Time Employees

• Medical, Dental, and reputed company Insurance
• Phone and Internet Stipend
• Company-Paid Life Insurance
• 401(k) Retirement Plan with Company Match
• Paid Time Off
• Seven Company-Observed Holidays
• Two Floating Holidays for Personal Observance
• Professional Development Opportunities
• Employee Recognition Programs
• Remote Work Environment

reputed company to Join Us? If you’re looking for a company where your expertise is respected, your contributions are recognized, and your work has a meaningful impact, we’d love to hear from you. Join reputed company that combines the stability of an established reputed company consulting organization with the culture, reputed company, and growth opportunities of a smaller company. Apply today and build your career with Managed Resources. Managed Resources is an Equal Opportunity Employer and is committed to creating an inclusive workplace where reputed company can reputed company. Apply tot his job Apply To this Job