Senior Clinical Coder (Inpatient Audit/DRG Validation) — Remote

Senior Clinical Coder (Inpatient Audit/DRG Validation) — Remote

Are you an experienced inpatient coder who enjoys digging into complex cases and ensuring claims are coded and paid correctly? We’re hiring a Senior Clinical Coder to perform retrospective review of inpatient facility claims, validate DRG assignments, and support accurate reimbursement decisions.

In this role, you’ll apply ICD-10-CM/PCS guidelines (and CPT/HCPCS as needed) to review medical records and claim details, document your findings, and communicate decisions through clear written determinations. You’ll also serve as a go-to resource for internal stakeholders and help mentor other coding team members.

What you’ll do

• Review inpatient facility claims and medical records for coding accuracy

• Validate DRG assignments and summarize findings

• Research coding guidance and payer policy to support decisions

• Prepare determination notices and concise documentation

• Identify patterns that may indicate billing errors, quality concerns, or fraud

• Support and mentor other coders; assist with coding projects

What you’ll bring

• Active CIC, CCS, or RHIT

• 5+ years clinical coding experience with strong inpatient facility focus

• Proven DRG validation and retrospective review/audit experience

• Confidence working independently in a fast-paced, remote setting

• Strong written communication and attention to detail