Inpatient Coder Associate, Payment Integrity jobs in United States
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Clover Health · 23 hours ago

Inpatient Coder Associate, Payment Integrity

Clover Health is a company focused on reinventing health insurance by combining data with empathy to improve member health. The Inpatient Coder Associate role involves ensuring accurate claims processing and reducing inappropriate medical spend through collaboration with various teams and maintaining regulatory compliance.

Health CareHealth InsuranceHospitalMedical

Responsibilities

Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues on a prospective and retrospective basis that drive inaccurate payments to providers
Proactively identify overpayments to ensure accurate claims payments on inpatient services
Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures
Communicate effectively while building trust and lasting partnerships both laterally and vertically across multi-discipline teams
Communicate effectively both internally and externally to ensure accurate claims adjudication and proper provider notification

Qualification

CCS certificationDRG pricing methodologyInpatient clinical codingMedicare Advantage experienceExcelPowerPointInterpersonal skillsCommunication skills

Required

You hold a CCS certification or similar inpatient coding certification; required
Knowledge of DRG pricing methodology; required

Preferred

You have 1-2 years of experience in inpatient clinical coding; preferred
Medicare or Medicare Advantage payment integrity or claims operations experience; preferred
You are technologically savvy with strong computer skills in Excel and PowerPoint

Benefits

401k matching
Comprehensive medical, dental, and vision coverage
No-Meeting Fridays
Monthly company holidays
Access to mental health resources
Generous flexible time-off policy
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

Company

Clover Health

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Clover is a healthcare technology company helping members live their healthiest lives with its Medicare Advantage plans.

Funding

Current Stage
Public Company
Total Funding
$1.62B
Key Investors
GreenoaksSequoia CapitalFirst Round Capital
2021-11-17Post Ipo Equity· $300M
2021-01-08Post Ipo Equity· $400M
2021-01-08IPO

Leadership Team

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Andrew Toy
Chief Executive Officer and Board Member (NASDAQ : CLOV)
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Jamie Reynoso
Chief Executive Officer
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Company data provided by crunchbase