Inpatient Coder Associate (Payment Integrity)

TL;DR

Inpatient Coder Associate (Payment Integrity): Ensuring accurate medical claims processing and regulatory compliance with an accent on DRG validation and overpayment identification. Focus on collaborating with clinical and claims teams to verify clinical rationale and maintain high quality assurance standards.

Location: Remote (USA)

Salary: $80,000 - $110,000 USD

Company

hirify.global is a healthcare technology company reinventing health insurance by combining data-driven analytics with human empathy to provide personalized care.

What you will do

• Review claims for DRG-related issues on both prospective and retrospective bases.
• Proactively identify overpayments to ensure accurate claims processing for inpatient services.
• Collaborate with medical doctors to verify the clinical rationale behind billed procedures.
• Communicate effectively across multi-disciplinary teams to ensure accurate claims adjudication.
• Maintain regulatory compliance standards within clinical review workflows.

Requirements

• Must hold a CCS or CIC certification.
• Knowledge of DRG pricing methodology is required.
• Must be based in the USA.
• Technologically savvy with strong skills in Excel and PowerPoint.
• 1-2 years of experience in inpatient clinical coding is preferred.
• Experience with Medicare or Medicare Advantage payment integrity is preferred.

Culture & Benefits

• Competitive base salary with equity opportunities and performance-based bonuses.
• Comprehensive medical, dental, and vision coverage.
• Remote-first culture with flexible time-off policy and No-Meeting Fridays.
• 401k matching and regular compensation reviews.
• Professional development funding and mentorship programs.
• Monthly stipends for cell phone, internet, and office setup.