Coding Compliance and Denials Manager - FT - Days
Vitruvian Health · Posted Nov 9, 2026
- Dalton, Georgia, United States
- On-site
- Full-time · Manager
- 3+ years
The HIM Manager of Coding Compliance and Denials Management performs advanced level work related to clinical and DRG denial management. The individual is responsible for managing denials related to referral, authorizations, notifications, non-coverage, medical necessity, DRGs and others as assigned.
Responsibilities
- Perform advanced level work related to clinical and DRG denial management
- Conduct comprehensive reviews of medical necessity denial and DRG Denial
- Review medical records to determine if a revised claim needs to be submitted, if a retro authorization needs to be obtained, or if a written appeal is needed
- Write and submit professionally written appeals including compelling arguments based on clinical documentation, third-party payer medical policies, and contract language
- Handle audit-related/compliance responsibilities and administrative duties
Requirements
- Graduate of approved RHIA or RHIT program
- Nice to have: Epic experience