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 healthcare organizations nationwide to improve performance, strengthen revenue 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 built.

At Managed Resources, you’ll find the stability and reputation of an established healthcare consulting firm combined with the accessibility, collaboration, and growth opportunities of a smaller organization. Here, your contributions are visible, your ideas are welcomed, and your work makes a meaningful impact.

Compensation

Salary Range: $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 Vision 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 Matters

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 believe the people closest to the work often have the best ideas.

Feeling Valued Matters

We believe 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 connection 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 engaged and supportive culture.

Opportunities to Learn and Grow

Whether you’re looking to deepen your expertise, expand your skill set, or take the next step in your career, Managed Resources supports continuous 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 success, we offer stability, industry expertise, and long-standing client relationships.

As a smaller organization, employees have the opportunity to build meaningful relationships, gain visibility with leadership, contribute ideas, influence change, and make a measurable impact on the organization.

Your work matters here.

About the Opportunity

The Clinical Appeals & CDI Manager will lead a team 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 revenue recovery for the client. In addition to managing core appeal and audit functions, this role provides leadership and operational support for special projects to ensure flexible, responsive coverage that meets client needs. 

Why This Role Matters

What You’ll Gain

• Flexibility of a remote work environment
• Visibility and access to leadership
• Opportunity to contribute ideas and influence change
• Professional development and career growth opportunities
• Meaningful work supporting healthcare organizations nationwide
• A collaborative culture that values employee success, 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.
• Develop 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 related deliverables in accordance with established service level.
• Develop 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 develop team members to support individual performance, engagement, and professional growth.
• Ensure all 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 outcomes.
• 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 when department performance does not meet established expectations or key performance metrics, and develop, 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 within 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 (CCS) 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 lead, coach, and develop a team 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 Microsoft Office
• Ability to examine financial and clinical data trends and provide recommended action plans.
• Integrity and commitment to excellence.
  

Benefits & Perks

Full-Time Employees

• Medical, Dental, and Vision 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

Ready 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 a team that combines the stability of an established healthcare consulting organization with the culture, connection, and growth opportunities of a smaller company.

Apply today and build your career with Managed Resources.

Managed Resources, Inc. is an Equal Opportunity Employer and is committed to creating an inclusive workplace where all employees can thrive.