Ethos is hiring an Inpatient Clinical Coder

Scout Motors is looking for an Inpatient Clinical Coder to join our Payment Integrity team. In this role, you will ensure accurate claims payments by reviewing inpatient claims for DRG-related issues and identifying overpayments. You will partner with clinical, claims, and tech teams and communicate directly with providers to verify clinical rationale.

What You'll Do

• Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues on a prospective and retrospective basis.
• 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.
• Coordinate the identification of provider DRG denials and upcoding.

What We're Looking For

• Hold a CCS or CIC certification.
• Knowledge of DRG pricing methodology.

Nice to Have

• 1-2 years of experience in inpatient clinical coding.
• Medicare or Medicare Advantage payment integrity or claims operations experience.
• Technologically savvy with strong computer skills in Excel and PowerPoint.

Technical Stack

• Excel
• PowerPoint

Team & Environment

You will be part of the Payment Integrity team sitting at the intersection of Clover's provider Network, Claims, and Tech teams.

Benefits & Compensation

• Compensation: $80,000 to $110,000 + equity opportunities.
• Competitive base salary and equity opportunities.
• Performance-based bonus program.
• 401k matching.
• Comprehensive medical, dental, and vision coverage.
• No-Meeting Fridays.
• Monthly company holidays.
• Access to mental health resources.
• Generous flexible time-off policy.
• Learning programs, mentorship, professional development funding.
• Regular performance feedback and reviews.
• Employee Stock Purchase Plan (ESPP) offering discounted equity.
• Reimbursement for office setup expenses.
• Monthly cell phone & internet stipend.
• Paid parental leave for all new parents.

Work Mode

This is a remote position open to candidates in the USA.

We are an Equal Opportunity Employer. From Clover’s inception, Diversity & Inclusion have always been key to our success. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company. Inclusion is everyone's responsibility.