DRG Denials Specialist

Job Description

Networks Connect is conducting a search for our client. We are hiring an experienced and detail-focused DRG Denials Specialist to support coding integrity, appeals management, and denial resolution workflows in an acute care hospital setting. This position is ideal for certified coding or CDI professionals with experience in hospital-based revenue cycle operations and denial prevention. As a key contributor to the Denials Management Team, you will collaborate with Clinical Documentation Improvement (CDI) and Coding Analysts to track trends, support appeals, and drive workflow efficiency. Candidates must demonstrate strong analytical abilities, excellent written communication, and the ability to work autonomously in a fast-paced healthcare environment.

Earnings

$39- $49 hourly

Duties

• Manage all aspects of DRG-related denial workflows including documentation, follow-up, and appeals
• Timely submission of denial responses and accurate recording of appeal outcomes
• Analyze denial data to identify patterns, root causes, and educational opportunities
• Collaborate with the DRG Clinical and Coding teams to optimize cross-functional workflows
• Identify and report front-end activities impacting the denials process
• Assist with the preparation of performance improvement strategies and documentation standardization
• Maintain detailed records and contribute to internal reporting for denials metrics
• Provide backup support for related HIM denial tasks when needed
• Uphold all quality and compliance standards across Denials, CDI, and Coding practices
• Stay up to date with Medicare, payer guidelines, and appeals regulations

Requirements

• Minimum 3 years of hospital-based coding and/or CDI experience
• Experience working in a remote setting
• Local to the Greater Dallas–Fort Worth (DFW) area or open to occasional on-site visits
• Prior experience with denial prevention and appeals in an academic or high-volume hospital setting

License / Certification

• Bachelor’s degree in Health Information Management or related field
• CCDS (Certified Clinical Documentation Specialist)
• CDIP (Clinical Documentation Improvement Practitioner)
• CCS (Certified Coding Specialist)
• CIC (Certified Inpatient Coder)

Benefits

• Zero-cost PPO plan for employee-only coverage (available Day One)
• 100% preventive care coverage, no copay
• Paid Time Off (PTO) and Paid Parental Leave
• Tuition Reimbursement and support for continued education
• Public Service Loan Forgiveness (PSLF) eligible employer
• Teacher Retirement System (TRS) retirement plans
• Access to wellness programs and professional development resources