Job Title: Senior Clinical Coder
Job ID: 86412
Location: Arizona, USA – Remote
Overview
We are seeking an experienced Senior Clinical Coder to join a high-performing clinical operations team. In this role, you will serve as a subject matter expert in medical claims coding and DRG validation, performing retrospective reviews for both inpatient and outpatient services to ensure accurate coding, compliance, and appropriate reimbursement. This position plays a key role in supporting medical directors, claims teams, quality management, and provider review processes by delivering detailed coding analysis, determinations, and education.
What you will be doing
Serve as the SME for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding
Perform DRG validation and retrospective medical claims reviews
Analyze inpatient and outpatient claims for coding accuracy and pricing determinations
Prepare determination letters and written review outcomes
Identify potential fraud, quality concerns, and coding discrepancies
Provide training and mentorship to clinical coding staff
Support cross-functional teams with coding guidance and review findings
Research medical policy, benefits, limitations, and current coding guidelines
Ensure timely completion of reviews in accordance with performance standards
Maintain accurate documentation within medical management and claims systems
Escalate complex cases to the Medical Director when appropriate
What you must have
High School Diploma or GED
One of the following active credentials:
CIC – Certified Inpatient Coder
CCS – Certified Coding Specialist
RHIT – Registered Health Information Technician
Minimum 5+ years of clinical coding experience (facility and/or professional)
Minimum 3+ years of inpatient and/or outpatient claims processing experience
Experience working in a fast-paced production environment
Ability to obtain and maintain a favorable background investigation
U.S. Citizenship required
Nice to have
Experience in managed care, health insurance, or private healthcare industry
Familiarity with government healthcare programs and guidelines
Core Competencies
Advanced inpatient facility coding & DRG validation expertise
Strong analytical and problem-solving skills
High attention to detail and organizational ability
Ability to manage large volumes of complex information
Independent, deadline-driven work style in a remote environment
Effective cross-functional communication and collaboration
Proficiency in Microsoft Word, Excel, and multi-system environments
Salary/Rate Range
$80,000 – $90,000 annually
Other Information
100% Remote – must work from an approved state
Ability to work independently in a home office setting
Prolonged computer work and sitting required
Flexibility to support varying work schedules if needed
Thank you for your interest in this opportunity. If you are selected to move forward in the process, we will contact you directly. If you do not hear from us, we encourage you to continue visiting our website for other roles that may be a good fit.
For more information about TEEMA and to consider other career opportunities, please visit our website at www.teemagroup.com
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