Remote Inpatient Clinical Coder - Payment Integrity

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

Benefits offered by this job

Competitive base salary?

Equity opportunities

401k matching

Remote-first culture

Monthly cell phone & internet stipend

Paid parental leave

Job summary

Clover Health is seeking an Inpatient Clinical Coder to ensure accurate payment of medical claims and identify overpayments within a remote, USA-based role. You’ll work with Clinical, Claims, and Payment Integrity colleagues to review DRG-related issues and verify clinical rationale with MDs, contributing to compliant, efficient claim processing.

Required CCS/CIC certification and 1–2 years of inpatient coding experience, with strong Excel/PowerPoint skills.

Qualifications

• CCS or CIC certification required.
• Knowledge of DRG pricing methodology required.
• 1-2 years of inpatient clinical coding experience preferred.
• Medicare or Medicare Advantage payment integrity or claims operations experience preferred.
• Strong computer skills in Excel and PowerPoint.

Responsibilities

• Partner with Clinical, Claims, and Payment Integrity teams to review claims for DRG-related issues to prevent inaccurate payments.
• Proactively identify inpatient service overpayments to ensure accurate payments.
• Collaborate with MDs to verify clinical rationale behind billed procedures.
• Communicate effectively to ensure accurate claims adjudication and provider notification.

Skills

CCS/CIC certification

DRG pricing knowledge

Inpatient coding experience

Medicare/Medi-care PI experience

Excel/PowerPoint proficiency

Tools

Excel

PowerPoint

Job description

Clover Health is seeking an Inpatient Clinical Coder to ensure accurate payment of medical claims and identify overpayments within a remote, USA-based role. You’ll work with Clinical, Claims, and Payment Integrity colleagues to review DRG-related issues and verify clinical rationale with MDs, contributing to compliant, efficient claim processing.

Required CCS/CIC certification and 1–2 years of inpatient coding experience, with strong Excel/PowerPoint skills.