Senior Inpatient Clinical Coder – DRG Expert (Remote)

TEEMA Solutions Group; Sarasota (FL); Remote; USD 80,000 - 90,000; Full time

Job summary

TEEMA Solutions Group is seeking a Senior Clinical Coder for a fully remote opportunity focused on inpatient facility coding and DRG validation. You will support clinical operations teams in complex medical claims reviews and ensure coding accuracy.

The ideal candidate has over 5 years of clinical coding experience and a CCS certification. This role offers long-term potential for permanent employment.

Qualifications

• 5+ years of clinical coding experience.
• 3+ years of inpatient facility coding.
• Strong knowledge in DRG validation and hospital/facility coding.

Responsibilities

• Perform retrospective reviews of inpatient and outpatient medical claims.
• Validate DRGs and ensure accurate reimbursement.
• Apply ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding guidelines.
• Review claims for coding accuracy, compliance, and payment integrity.
• Prepare coding determinations and written review summaries.
• Identify coding discrepancies, quality concerns, and potential fraud.
• Serve as a coding subject matter expert for clinical and operational teams.
• Mentor and support fellow coding professionals.
• Research medical policies, coding regulations, and benefit guidelines.
• Escalate complex coding issues to Medical Directors when appropriate.

Skills

Clinical coding

DRG validation

ICD-10-CM coding

CPT coding

CPT coding

HCPCS coding

Education

High School Diploma or GED

CCS certification

Job description

TEEMA Solutions Group is seeking a Senior Clinical Coder for a fully remote opportunity focused on inpatient facility coding and DRG validation. You will support clinical operations teams in complex medical claims reviews and ensure coding accuracy.

The ideal candidate has over 5 years of clinical coding experience and a CCS certification. This role offers long-term potential for permanent employment.