Senior Inpatient Coder & DRG Expert — Remote

TEEMA; Arizona; Remote; USD 80,000 - 110,000; Full time

Job summary

TEEMA is seeking a Senior Clinical Coder to serve as a subject matter expert in ICD-10-CM/PCS, CPT, and HCPCS coding. This remote role focuses on DRG validation, retrospective claims reviews, and ensuring accurate reimbursement across inpatient and outpatient services.

You will collaborate with medical directors, claims operations, and quality management, training staff and escalating high‑risk cases as needed.

Qualifications

• CCS certification or equivalent credential required.
• Minimum five years of clinical coding experience.
• Minimum three years inpatient or outpatient claims processing experience.
• Experience in fast-paced, production-driven environments.
• Ability to obtain and maintain a favorable background check.

Responsibilities

• Serve as subject matter expert for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding
• Perform DRG validation and retrospective medical claims reviews
• Analyze inpatient and outpatient claims for coding accuracy and reimbursement determinations
• Prepare clear, detailed determination letters and written review outcomes
• Identify coding discrepancies, potential fraud, and quality concerns
• Provide training, mentorship, and guidance to clinical coding staff
• Collaborate with cross-functional teams to support coding inquiries and review findings
• Research and apply medical policies, benefits, limitations, and current coding guidelines
• Ensure timely completion of coding reviews in alignment with performance standards
• Maintain accurate and thorough documentation within medical management and claims systems
• Escalate complex or high‑risk cases to the Medical Director as appropriate

Skills

CCS

5+ years clinical coding

3+ years inpatient/outpatient claims

Background check ready

Education

High School Diploma or GED

Job description

TEEMA is seeking a Senior Clinical Coder to serve as a subject matter expert in ICD-10-CM/PCS, CPT, and HCPCS coding. This remote role focuses on DRG validation, retrospective claims reviews, and ensuring accurate reimbursement across inpatient and outpatient services.

You will collaborate with medical directors, claims operations, and quality management, training staff and escalating high‑risk cases as needed.