certified inpatient coder

TEEMA Group

<div><h2 class="jobSectionHeader">Role Summary</h2>
The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation, playing a critical role in ensuring coding accuracy, regulatory compliance, and appropriate reimbursement across inpatient and outpatient services.
In this role, you will conduct detailed retrospective claims reviews, provide expert-level coding analysis, and support cross-functional teams including medical directors, claims operations, and quality management. This position is ideal for a highly analytical professional who thrives in a fast-paced, remote environment and is passionate about accuracy, compliance, and continuous improvement in healthcare operations.<h2 class="jobSectionHeader">
Duties &amp; Responsibilities</h2><ul><li>
Serve as a subject matter expert for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding</li><li>
Perform DRG validation and retrospective medical claims reviews</li><li>
Analyze inpatient and outpatient claims for coding accuracy and reimbursement determinations</li><li>
Prepare clear, detailed determination letters and written review outcomes</li><li>
Identify coding discrepancies, potential fraud, and quality concerns</li><li>
Provide training, mentorship, and guidance to clinical coding staff</li><li>
Collaborate with cross-functional teams to support coding inquiries and review findings</li><li>
Research and apply medical policies, benefits, limitations, and current coding guidelines</li><li>
Ensure timely completion of coding reviews in alignment with performance standards</li><li>
Maintain accurate and thorough documentation within medical management and claims systems</li><li>
Escalate complex or high-risk cases to the Medical Director as appropriate</li></ul><h2 class="jobSectionHeader">
Required Qualifications</h2><ul><li>
High School Diploma or GED</li><li>
Active credential in one of the following:<ul><li>
Certified Inpatient Coder (CIC)</li><li>
Certified Coding Specialist (CCS)</li><li>
Registered Health Information Technician (RHIT)</li></ul></li><li>
Minimum of five (5) years of clinical coding experience (facility and/or professional)</li><li>
Minimum of three (3) years of inpatient and/or outpatient claims processing experience</li><li>
Experience working in a fast-paced, production-driven environment</li><li>
Ability to obtain and maintain a favorable background investigation</li><li>
U.S. Citizenship required</li></ul><h2 class="jobSectionHeader">
Desired Qualifications</h2><ul><li>
Experience within managed care, health insurance, or private healthcare industry</li><li>
Familiarity with government healthcare programs and regulatory guidelines</li><li>
Advanced expertise in inpatient facility coding and DRG validation</li><li>
Strong analytical, critical thinking, and problem-solving skills</li><li>
High attention to detail with strong organizational capabilities</li><li>
Ability to manage large volumes of complex information independently</li><li>
Effective communication and collaboration across multidisciplinary teams</li><li>
Proficiency in Microsoft Word, Excel, and multi-system environments</li></ul><h2 class="jobSectionHeader">
Location &amp; Work Type</h2>
100% Remote (must reside in an approved state) 
Full-time position<ul><li>
Independent home office work environment required</li><li>
Prolonged computer use and sitting required</li><li>
Flexibility to support varying work schedules as needed</li></ul>
#Workwolf</div>

Sr. Inpatient Clinical Coder

HonorHealth

<div>Overview: Looking to be part of something more meaningful? At HonorHealth, you&rsquo;ll be part of a team, creating a multi-dimensional care experience for our patients. You&rsquo;ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact. HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more. Join us. Let&rsquo;s go beyond expectations and transform healthcare together. HonorHealth is one of Arizona&rsquo;s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 17,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com. Responsibilities: Job Summary 
Assigns and sequences ICD-10-CM, ICD-10-PCS, CPT and HCPCS codes through review of inpatient or outpatient clinical documentation and diagnostic results as appropriate for billing, internal and external reporting, research, and regulatory compliance. 
Essential Functions 
<ul><li>
Inpatient: Assigns and sequences ICD-10-CM and ICD-10-PCS diagnostic and procedural codes for inpatient accounts within HonorHealth. Reviews physician documentation &amp; coding for appropriateness &amp; accuracy and makes corrections following Medicare &amp; AMA coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Addresses applicable coding edits. Assigns DRGs as applicable. Outpatient: Assigns and sequences ICD-10-CM, CPT and HCPCs diagnostic and procedural codes for outpatient accounts within HonorHealth. Reviews physician documentation &amp; coding for appropriateness &amp; accuracy and makes corrections following Medicare &amp; AMA coding guidelines. Utilizes electronic medical record and computer-assisted coding (CAC) software. Addresses NCCI, OCE, LCD, and other applicable coding edits.</li><li>
Inpatient: Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate ICD code selection. Outpatient: Complies with system-wide coding practices to meet corporate compliance guidelines and to ensure appropriate and effective reimbursement with Patient Financial Services, medical staff and various departments. Reviews and analyzes medical records for accurate ICD and CPT code selection.</li><li>
Inpatient/Outpatient: Communicates and assists in education with an audience that may include physicians and clinical staff.</li><li>
Inpatient: Assists Patient Financial Services with interpretation and selection of appropriate ICD codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters. Outpatient: Assists Patient Financial Services with interpretation and selection of appropriate ICD, CPT, and HCPCs codes and /or other information requested for accurate billing and reimbursement. Possesses knowledge and understanding of failed bill parameters.</li><li>
Inpatient/Outpatient: Performs outpatient charge validation/reconciliation for outpatient coding to ensure all submitted charges are posted timely and balance with total submitted charges. Assigns charges as applicable.</li><li>
Inpatient/Outpatient: Resolves routine coding issues/problems and appropriately seeks assistance from supervisor.</li><li>
Performs other duties as assigned.</li></ul>
Education 
<ul><li>
Associate's Degree in health related field - Preferred</li><li>
High School Diploma or GED - Required</li></ul>
Experience 
<ul><li>
2 years Inpatient: Hospital inpatient coding. Outpatient: Coding outpatient accounts which may include Emergency department, newborn, obstetrics, day surgery, observation, wound care, radiology, laboratory, series, infusion, oncology, and rehab therapy. - Preferred</li><li>
Other Inpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM and ICD-10-PCS codes. Outpatient: Knowledge of medical terminology, anatomy and physiology, knowledge of medical record requirements, HIPAA privacy rules, and assigning and sequencing ICD-10-CM, CPT, and HCPCs codes. - Required</li><li>
Other Inpatient: Knowledge of pathology, pharmacology, microbiology, radiology, and other clinical specialties. Outpatient: Working knowledge of charging and billing processes. Working knowledge of Medicare, NCCI, OCE, LCD, NCD, and other claim edit guidelines and protocol. - Preferred</li></ul>
Licenses and Certifications 
<ul><li>
CCA (Certified Coding Apprentice) with successful certification of CCS in 6 months OR Inpatient: CCS (Certified Coding Specialist), or CIC (Certified Inpatient Coder), or RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) Outpatient: CPC-H (Certified Professional Coder-Hospital Outpatient), or CPC (Certified Professional Coder), or COC (Certified Outpatient Coder), or CCS (Certified Coding Specialist), or RHIT (Registered Health Information Technician) or RHIA (Registered Health Information Administrator) - Required</li><li>
CCS, CPC-H/COC, CIC, RHIT, or RHIA - Preferred</li></ul>
Facility: HonorHealth Support Services Department: Coding Work Hours: Mon-Fri 40 hrs/week. 8am - 4:30 pm Hours flexible. Shift: Day Position Type: Full-Time</div>

Coder 1 Outpatient

Cheyenne Regional Medical Center

<div>Job Requirements
 
A Day in the Life of a Coder II 
 
Under general supervision, the Coder II is responsible for the timely review of medical record documentation to abstract demographic data and assign diagnoses, procedures, and modifiers for statistical classification and reimbursement purposes. Ensures the accuracy of the reason for admission, extent of care received and level of severity of illness. Utilizes software applications, electronic and printed coding references to perform coding related tasks. 
 
Why Work at Cheyenne Regional? 
<ul><li>
403(b) with 4% employer match</li><li>
ANCC Magnet Hospital</li><li>
21 PTO days per year (increases with tenure)</li><li>
Education Assistance Program</li><li>
Employee Sponsored Wellness Program</li><li>
Employee Assistance Program</li><li>
Loan Forgiveness Eligible
</li></ul>Here is What You Will Be Doing:<ul><li>
Selects appropriate assignments for coding/abstracting from work queues.
</li><li>Uses 3M Encoder, various software applications, electronic and printed coding references to accurately code diagnosis and procedures for patient encounters
</li><li>Meets or exceeds current minimum accuracy expectations in selection/sequencing of principal and secondary diagnosis while maintaining productivity requirements as outlined by management and administration.
</li><li>Contacts physician and/or ancillary departments when additional information is needed to accurately code the record.
</li><li>Strives to decrease pending accounts on all patient types.
</li><li>Completes record or reassigns record to appropriate work queues 100% of the time.
</li><li>Maintains patient, medical record, department and employee confidentiality at all times.
</li><li>Provides feedback regarding documentation and coding.
</li><li>Successfully completes requirements for maintaining credentials.
</li><li>Maintains productivity and daily activities through time tracking software.
</li></ul>Desired Skills:<ul><li>
Thorough knowledge of coding, coding guidelines and compliance
</li><li>Thorough knowledge Anatomy &amp; Physiology and medical terminology
</li><li>Knowledge of encoder and data abstracting software
</li><li>Ability to interact with physicians and ancillary departments
</li><li>Ability to work with all persons in and out of the department
</li><li>Ability to work independently
</li><li>Strong organizational skills with attention to detail
</li><li>Strong oral, written, and interpersonal communication skills
</li><li>Ability to interact respectfully with diverse cultural and socio-economic populations
</li></ul>Here is What You Need:<ul><li>
Certification (must meet one of the following):</li><li>
Current Certified Coding Associate (CCA) from the American Health Information Management Association (AHIMA)</li><li>
Current Certified Coding Specialist (CCS) from the American Health Information Management Association (AHIMA)</li><li>
Current Registered Health Information Administrator (RHIA) from the American Health Information Management Association (AHIMA)</li><li>
Current Registered Health Information Technician (RHIT) from the American Health Information Management Association (AHIMA)</li><li>
Current Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC)</li><li>
Current Certified Outpatient Coder (COC) from the American Academy of Professional Coders (AAPC)</li><li>
Current Certified Inpatient Coder (CIC) from the American Academy of Professional Coders (AAPC)</li><li>
RADIATION ONCOLOGY ONLY: Current Radiation Oncology Certified Coder (ROCC) from the American Medical Accounting and Consulting (AMAC)</li><li>
Three (3) or more years of medical related coding experience</li><li>
Pre-Hire: Must pass coding proficiency pre-hire test with a minimum score of 70%</li></ul>
Nice to Have:<ul><li>
Advanced education in anatomy and medical terminology</li></ul>
About Cheyenne Regional: 
Cheyenne Regional Medical Center was founded in 1867 as a tent hospital by the Union Pacific Railroad to treat workers injured while building the transcontinental railroad. Today, we are the largest hospital in the state of Wyoming, employing over 2,000 people, and treating over 350,000+ patients from southeastern Wyoming, western Nebraska, and northern Colorado. We pride ourselves on patient and employee experience by living our core values of Integrity, Caring, Compassion, Respect, Service, Teamwork and Excellence to great health. 
 
Our team makes a difference every day by providing trusted healthcare expertise through a passionate and I.N.S.P.I.R.E.(ing) approach with a personal touch. By living our values, we aim to achieve our goal of becoming a 5-star rated hospital, providing critical support and resources to our community and the greater region we serve. If you are eager to make a difference and passionate about healthcare, we encourage you to apply today!</div>

Coder II

Machinify

<div><div>Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We&rsquo;re constantly reimagining what&rsquo;s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.</div><div> 

About the Opportunity 
As part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. This position requires an in-depth understanding of clinical guidelines, coding protocols, and regulatory requirements to ensure accurate payment determinations.

In this role, you will meticulously document findings, provide detailed clinical, policy, and regulatory support and collaborate with relevant stakeholders to ensure compliance with payment standards. Your expertise will be critical in ensuring that payment decisions are supported by accurate and complete documentation, ultimately contributing to the integrity and efficiency of the payment process.

What you&rsquo;ll do
<ul>
<li>Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement.</li>
<li>Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers.</li>
<li>Collaborate with team leaders to ensure thorough review of DRG denials.</li>
<li>Conduct audits in alignment with organizational quality and timeliness standards.</li>
<li>Use proprietary auditing systems proficiently to make consistent determinations and generate audit letters.</li>
<li>Recommend improvements to the audit system to enhance efficiency.</li>
<li>Ensure compliance with HIPAA regulations for protected health information.</li>
<li>Perform other duties as assigned.</li>
</ul>
What you bring (Role Requirements)

Education Requirements:
<ul>
<li>An associate or bachelor&rsquo;s degree in nursing (active/unrestricted license); or in health information management is required.</li>
<li>Work experience may be considered in lieu of formal education at leadership discretion.</li>
</ul>
Certification (at least one of the following is required):
<ul>
<li>RHIA - Registered Health Information Administrator</li>
<li>RHIT- Registered Health Information Technician</li>
<li>CCDS - Certified Clinical Documentation Specialist</li>
<li>CDIP - Clinical Documentation Improvement Practitioner</li>
<li>CCS - Certified Coding Specialist</li>
<li>CIC - Certified Inpatient Coder</li>
</ul>
Qualifications:
<ul>
<li>Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required</li>
<li>Strong focus on quality and attention to detail.</li>
<li>Deep curiosity and analytical skills to understand root causes of events and behaviors.</li>
<li>Proven ability to apply critical judgment in clinical and coding determinations.</li>
<li>In-depth knowledge of clinical criteria and documentation requirements to support code assignments.</li>
<li>Expert in DRG methodologies (e.g., MS &amp; APR).</li>
<li>Expertise in ICD-10-CM/PCS coding, UHDDS definitions, Official Coding Guidelines, and AHA&rsquo;s Coding Clinic Guidelines.</li>
<li>Ability to work independently and efficiently with minimal supervision.</li>
</ul>
What We Offer:
<ul>
<li>Work from anywhere in the US! Machinify is digital-first.</li>
<li>Top Medical/Dental/Vision offerings</li>
<li>FSA/HSA</li>
<li>Tuition reimbursement</li>
<li>Competitive salary, 401(k) with company match</li>
<li>PTO</li>
<li>Additional health and wellness benefits and perks
</li><li>Flexible and trusting environment where you&rsquo;ll feel empowered to do your best work</li>
</ul>
The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks.

Pay range: $90,000 - $115,000, plus quarterly bonus.</div><div><div>
Equal Employment Opportunity at Machinify</div>
<div></div>
<div>We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/</div></div></div>

Inpatient Claims Auditor | Medical Coding [remote] New

Pride Health

<div>
 
 
 Certified Medical Coders
 
 
 
 
 
 
 
 Work Arrangement:
 
 
 <ul>
 <li>
 Full-time | 40 hours per week | Monday&ndash;Friday
 </li>
 <li>
 EPIC &amp; 3M experience required
 </li>
 <li>
 CCS and CPC certification required
 </li>
 </ul>
 
 
 
 
 
 Position Summary
 
 
 
 The Certified Medical Coder is responsible for accurately and compliantly assigning diagnostic and procedural codes for services provided in an acute care setting. Open positions include
 
 outpatient
 
 and
 
 emergency department (ED)
 
 coding, as
 
 well as inpatient
 
 coding. Candidates must demonstrate strong technical skills, regulatory knowledge, and proficiency with EPIC and 3M applications.
 
 
 
 
 
 
 Essential Duties (Both Roles)
 
 
 <ul>
 <li>
 Perform coding using ICD-10, CPT-4, and encoder tools in alignment with industry guidelines
 </li>
 <li>
 Ensure all coding complies with federal, payer, and regulatory standards
 </li>
 <li>
 Review clinical documentation to assign correct diagnoses and procedure codes
 </li>
 <li>
 Utilize EPIC, 3M/HDS, Microsoft Office, and other coding software
 </li>
 <li>
 Maintain knowledge of anatomy, physiology, and disease processes
 </li>
 <li>
 Research and resolve coding-related issues
 </li>
 <li>
 Support coder education/training processes as needed
 </li>
 <li>
 Collaborate with clinical and revenue cycle teams to promote accuracy
 </li>
 </ul>
 
 
 
 
 
 Requirements
 
 
 
 
 
 
 
 General Requirements (Applies to Both Roles)
 
 
 <ul>
 <li>
 Minimum
 
 3 years of acute care medical coding experience
 
 </li>
 <li>
 Strong knowledge of
 
 ICD-10, CPT-4
 
 , and encoder tools
 </li>
 <li>
 Experience using
 
 EPIC
 
 and
 
 3M/HDS
 
 </li>
 <li>
 Understanding of anatomy, physiology, disease processes, payer rules, and coding guidelines
 </li>
 <li>
 Ability to analyze medical documentation for accurate code selection
 </li>
 <li>
 High School Diploma/GED required
 </li>
 </ul>
 
 
 
 
 
 Outpatient &amp; ED Coding &ndash; Role-Specific Requirements
 
 
 <ul>
 <li>
 Experience coding
 
 Outpatient
 
 services and
 
 Emergency Department (ED)
 
 encounters
 </li>
 <li>
 Proficiency in outpatient billing, CPT coding, same-day procedures, and ancillary services
 </li>
 <li>
 Accepted certifications:
 </li>
 <li>
 
 CCS &ndash; Required
 
 </li>
 <li>
 
 CPC &ndash; Accepted (Outpatient/ED only)
 
 </li>
 <li>
 RHIA, RHIT, CCP &ndash; Accepted but CCS/CPC preferred
 </li>
 </ul>
 
 
 
 
 
 Inpatient Coding &ndash; Role-Specific Requirements
 
 
 <ul>
 <li>
 Experience coding
 
 acute Inpatient
 
 hospital records
 </li>
 <li>
 Understanding of:
 </li>
 <li>
 
 MS-DRG / APR-DRG methodologies
 
 </li>
 <li>
 Inpatient-specific documentation and billing requirements
 </li>
 </ul>
 
 
 
 
 
 Education &amp; Certifications
 
 
 <ul>
 <li>
 High School Diploma or GED required
 </li>
 <li>
 Acceptable certifications based on role:
 </li>
 <li>
 CCS or CPC certification required
 </li>
 <li>
 RHIA, RHIT, CCP (accepted)
 </li>
 </ul>
 
 
 
 
 Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life &amp; disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
 
 
 
</div>

Medical Coder

Cosentus

Key Responsibilities<ul><li>Review inpatient medical records including admission notes, progress notes, operative reports, discharge summaries, and lab results</li><li>Assign accurate ICD-10-CM, ICD-10-PCS, CPT, and DRG codes for inpatient cases</li><li>Ensure compliance with DHA coding standards and UAE insurance regulations</li><li>Clarify incomplete or unclear documentation with physicians</li><li>Abstract clinical data into hospital information systems</li><li>Ensure accurate DRG assignment for reimbursement purposes</li><li>Participate in internal and external coding audits</li><li>Maintain strict patient confidentiality</li><li>Support denial management and claim resubmission processes</li></ul>Qualifications<ul><li>Bachelor&rsquo;s Degree in Health Information Management, Nursing, Pharmacy, or related healthcare field</li><li>Certified Professional Coder (CPC) or CPC-H from AAPC</li></ul>OR<ul><li>Certified Coding Specialist (CCS) from AHIMA</li><li>DHA License or Eligibility Letter (mandatory for Dubai)</li><li>Minimum 2&ndash;5 years of inpatient coding experience</li><li>Strong knowledge of DRG methodology</li></ul>Required Skills<ul><li>In-depth understanding of medical terminology, anatomy &amp; physiology</li><li>Knowledge of UAE insurance eClaims system</li><li>Strong analytical and documentation review skills</li><li>Attention to detail with high accuracy rate</li><li>Ability to work under deadlines</li><li>Good communication and coordination skills</li></ul>Job Type: Full-timePay: AED5,000.00 - AED9,500.00 per monthWork Location: In person

In Patient Certified Coder/ UAE Based

Search 10000+ Certified inpatient coder jobs near you this March. New roles added regularly across leading industries. Apply today.

10000 certified inpatient coder jobs Near Me

Sr. Inpatient Clinical Coder

Coder 1 Outpatient

Sr. Inpatient Clinical Coder

Coder II

Inpatient Claims Auditor | Medical Coding [remote] New

Medical Coder

In Patient Certified Coder/ UAE Based