Inpatient Sr Clinical Coder - Remote

Contract to Hire with 6 to 9 months average time on contract
Position Overview
Title: Inpatient Senior Clinical Coder
Type: Contract to Hire
Work Arrangement: Fully Remote (specific states to be confirmed)
Focus Areas: Inpatient coding, DRG assignment, and retrospective medical claims review
Key Responsibilities
Coding Expertise:
Conduct retrospective reviews of medical claims to determine appropriate coding and pricing.
Perform diagnosis and procedural coding for inpatient claims with DRG (Diagnosis-Related Grouping) assignment.
Serve as a subject matter expert for medical claims coding related to both outpatient and inpatient services.
Collaboration and Support:
Provide coding-related information to medical directors, providers, peer reviewers, and other stakeholders.
Assist non-clinical and clinical staff with coding and retrospective claims review processes.
Network and Provider Relations:
Act as the designated recipient for factual network provider claim review requests.
Develop determination letters as part of the review process.
Internal Coordination:
Work closely with Claims, Administration, Program Integrity, Quality Management, and subcontractors to ensure accurate coding and claims processing.
Requirements
Experience:
Strong background in inpatient coding and comprehensive understanding of DRG coding.
Certifications:
HRIT (Health Record Information Technology)
HRIA (Health Record Information Administration)
Leadership:
Ability to work under the direction of a DRG Supervisor or designee, demonstrating both independence and collaborative skills.
Additional Notes
Approved states for remote work to be specified by the employer.
This position is critical to ensuring compliance and accuracy in coding practices, supporting both operational and provider-related activities.