Remote DRG Inpatient Coding Validator (Senior)

Bazeta; United States; Remote; USD 76,000 - 99,000; Full time

Benefits offered by this job

ESPP

Office stipend

Cell phone stipend

Remote-first culture

Paid parental leave

Employee stock purchase plan

Job summary

Clover Health is seeking a Senior DRG Inpatient Coding Validator to ensure accurate claim payments and to support a compliant, efficient program remotely from the United States.

You will work with Clinical, Claims, and Payment Integrity teams, review DRG denials, participate in discussions with physicians, and contribute to improving reimbursement accuracy while maintaining regulatory standards.

Qualifications

• CCS or CIC certification; required.
• Knowledge of DRG pricing methodology; required.
• At least 1 year of direct inpatient clinical coding experience.

Responsibilities

• Review claims for DRG-related issues on prospective and retrospective basis.
• Identify overpayments to ensure accurate inpatient payments.
• Collaborate with MDs to verify clinical rationale behind billed procedures.
• Communicate effectively across multi-discipline teams.

Skills

DRG coding

Inpatient coding

MS Excel

PowerPoint

Job description

Clover Health is seeking a Senior DRG Inpatient Coding Validator to ensure accurate claim payments and to support a compliant, efficient program remotely from the United States.

You will work with Clinical, Claims, and Payment Integrity teams, review DRG denials, participate in discussions with physicians, and contribute to improving reimbursement accuracy while maintaining regulatory standards.