Remote Inpatient Coding Auditor

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

Benefits offered by this job

Equity opportunities

401k matching

No-Meeting Fridays

Remote-first culture

Paid parental leave

ESPP

Cell phone & internet stipend

Job summary

Clover Health is seeking an Inpatient Coding Specialist to support accurate claims payments and identify DRG-related issues. You will collaborate across Clinical, Claims, and Payment Integrity teams to review inpatient claims, identify overpayments, and verify the clinical rationale with MDs.

You will work in a remote-first environment with strong Excel/PowerPoint usage and opportunities for professional growth in a mission-driven HealthTech company.

Qualifications

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

Responsibilities

• Review claims for DRG-related issues to drive accurate payments.
• Identify overpayments to ensure correct inpatient payments.
• Consult with MDs to verify clinical rationale behind billed procedures.
• Communicate across multi-disciplinary teams to ensure proper adjudication.

Skills

Inpatient coding

DRG pricing methodology

Education

CCS or CIC certification

Tools

Excel

PowerPoint

Job description

Clover Health is seeking an Inpatient Coding Specialist to support accurate claims payments and identify DRG-related issues. You will collaborate across Clinical, Claims, and Payment Integrity teams to review inpatient claims, identify overpayments, and verify the clinical rationale with MDs.

You will work in a remote-first environment with strong Excel/PowerPoint usage and opportunities for professional growth in a mission-driven HealthTech company.