Inpatient Coder Associate, Payment Integrity

Job not on LinkedIn

🕒 May 22

🇺🇸 United States – Remote

💵 $63.8k - $83k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏥 Medical Billing and Coding

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 40%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Clover Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

🛡️ Insurance

🤖 Artificial Intelligence

Healthcare • Insurance • Artificial Intelligence

Clover Health is a healthcare technology company helping members live their healthiest lives with our Medicare Advantage plans. Focused on seniors who have historically lacked access to affordable and high-quality healthcare, Clover aims to provide care sustainably by improving medical outcomes while simultaneously lowering avoidable costs. They leverage a proprietary software platform, the Clover Assistant, to aggregate patient data and offer real-time recommendations to healthcare providers. Their services include affordable Medicare Advantage plans, a home care program, and they manage care for Medicare Advantage members across several U. S. states.

📋 Description

• Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG-related issues prospectively and retrospectively • Identify overpayments to ensure accurate claims payments on inpatient services • Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures • Build trust and lasting partnerships across multidisciplinary teams • Communicate internally and externally to ensure accurate claims adjudication and proper provider notification • Develop understanding of clinical coding practices and medical records review • Assist with DRG validation • Execute clinical review workflows autonomously • Maintain regulatory compliance standards

🎯 Requirements

• CCS or CIC certification; required • Knowledge of DRG pricing methodology; required • 1-2 years of experience in inpatient clinical coding; preferred • Medicare or Medicare Advantage payment integrity or claims operations experience; preferred • Strong computer skills in Excel and PowerPoint • Technologically savvy

🏖️ Benefits

• Competitive base salary • Equity opportunities • Performance-based bonus program • 401(k) matching • Regular compensation reviews • Comprehensive medical, dental, and vision coverage • No-Meeting Fridays • Monthly company holidays • Mental health resources • Generous flexible time-off policy • Remote-first culture supporting collaboration and flexibility • Learning programs • Mentorship • Professional development funding • Regular performance feedback and reviews • Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities • Reimbursement for office setup expenses • Monthly cell phone & internet stipend • Paid parental leave for all new parents