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Clover Health
DRG Inpatient Coding Validator
Remote · USA · Full time · Mid level
$76k–$99k / year
About the role
Ensure accurate claims payments and compliance by validating inpatient DRG coding and recovering overpayments. Collaborate with clinical and claims teams to maintain quality assurance standards.
What you’ll do
• Review claims for DRG related payment issues. • Identify overpayments on inpatient services. • Discuss clinical rationale with MDs. • Communicate internally and externally for claims accuracy. • Build partnerships across multi-discipline teams.
What you’ll bring
• CCS or CIC certification required. • Knowledge of DRG pricing methodology. • At least 1 year inpatient clinical coding experience. • Medicare or Medicare Advantage claims experience preferred. • Work authorization for USA required.
Life at Clover Health
Offers competitive salary, equity, bonuses, 401k matching, comprehensive health coverage, mental health resources, remote-first culture, and professional development.
About Clover Health
Clover Health reinvents health insurance using data and empathy to improve member health and healthcare outcomes.