DRG Coder

🕒 June 3

🏄 California – Remote

🏄 California – Remote

💵 $33 - $38 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Astrana Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

☁️ SaaS

🤝 B2B

👥 B2C

SaaS • B2B • B2C

Astrana Health is a healthcare company that operates community-focused clinics and a provider-facing technology platform to coordinate care across primary, urgent, and multi-specialty services. It supports providers and local communities by streamlining access to care, automating prior authorizations, and connecting patients with in-network clinicians. Astrana combines clinical services with doctor-built technology to improve patient experience and provider workflows.

📋 Description

• Review inpatient hospital records and assign accurate diagnosis and procedure codes • Determine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentation • Conduct coding validation and auditing to ensure compliance with payer and regulatory requirements • Identify documentation gaps and communicate opportunities to providers, hospitals, and Clinical Documentation Improvement (CDI) teams • Analyze denials and underpayments related to coding and DRG assignment • Support retrospective and concurrent reviews of high-cost admissions and outlier cases • Collaborate with utilization management, case management, finance, and contracting teams to optimize reimbursement and cost containment • Assist with internal and external audits, including RAC, Medicare Advantage, Medicaid, and commercial payer reviews • Provide education and mentoring to coding staff and other stakeholders • Monitor changes in coding guidelines, reimbursement methodologies, and regulatory requirements • Prepare reports and summaries related to coding accuracy, financial impact, and audit findings • Maintain confidentiality and compliance with HIPAA and company policies • Other duties as assigned

🎯 Requirements

• Associate’s degree in Health Information Management, Nursing, or related field • Minimum of 5 years of inpatient coding experience • Minimum of 2 years of advanced DRG validation, auditing, or hospital reimbursement experience • Certifications One or more of the following required: • CCS, RHIA, or RHIT from American Health Information Management Association • CIC or CPC from AAPC • Have advanced knowledge of ICD-10-CM, ICD-10-PCS, MS-DRG, and APR-DRG methodologies • Proficiency in coding software, electronic medical records, and Microsoft Office applications • You're great for the role if: • Experience working with Medicare Advantage, Medicaid, and commercial health plans • Experience in a delegated IPA, MSO, or managed care environment • Have a strong understanding of Medicare reimbursement and payer audit processes • Ability to interpret complex clinical documentation • Knowledge of utilization management, case management, and managed care operations • Strong analytical, organizational, and problem-solving skills • Ability to work independently and manage multiple priorities • Excellent written and verbal communication skills.

🏖️ Benefits

• This position is remotely based in the U.S. The home office is located at 600 City Parkway West 10th Floor, Orange, CA 92868. • This role is required to attend occasional in-person meetings with internal departments and external providers/hospitals, training, or audit purposes. • The national target pay range for this role is between $33.00 - $38.00. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.