Job Openings
Inpatient Clinical Coder
About the job Inpatient Clinical Coder
Position Title: Inpatient Clinical Coder
- Employment Type: Contract to Hire (6 to 9 months average contract duration)
- Compensation: $33.50 to $37.22 per hour
- Work Arrangement: Fully Remote (approved states only)
Role Summary
The Inpatient Clinical Coder will play a key role in reviewing and ensuring the accuracy of coding for inpatient claims and prior authorization requests. The position involves retrospective medical claims review, coding and pricing determinations, and diagnosis-related group (DRG) assignments.
Under the guidance of the DRG Supervisor or designee, the Clinical Coder will provide support and expertise to various teams and stakeholders, ensuring compliance with coding standards and processes.
Key Responsibilities
- Coding and Review
- Conduct coding reviews for prior authorization requests related to unlisted codes or services.
- Perform retrospective reviews of medical claims to ensure accuracy in coding and pricing.
- Execute diagnosis and procedural coding for inpatient (facility) claims, including DRG assignment.
- Collaboration and Expertise
- Provide coding-related information to medical directors, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and subcontractors as needed.
- Develop determination letters based on coding reviews.
- Support both non-clinical and clinical staff with coding, pricing, and retrospective claims review processes.
- Stakeholder Support
- Assist in maintaining compliance and improving accuracy across medical claims processes.
- Act as a resource for retrospective review and pricing-related queries.
Qualifications
- Experience:
- Solid background in inpatient facility coding.
- Strong understanding of DRG (Diagnosis-Related Grouping) coding principles.
- Certifications (Preferred but not Mandatory):
- RHIT (Registered Health Information Technician)
- RHIA (Registered Health Information Administrator)
Additional Information
- Fully remote position with work authorized in approved states.
- Compensation adjusted based on state-specific markups.
- Reporting directly to the DRG Supervisor or their designee.