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Remote Medical Coder Government Jobs in Tennessee

EnableComp

DRG Validator/Reviewer (REMOTE)

Franklin, TN · Remote

Match clinical documentation in the medical record to corresponding ICD-10 codes, ensuring DRG ... This role is primarily office-based or remote, depending on company policy, with extensive computer ...

Pae

Senior Structural Engineer - Remote/Hybrid

Oak Ridge, TN · On-site +1

$96K - $130K/yr

Sole US citizenship required (to comply with government customer requirements and/or applicable ... Experience implementing local and national codes such as IBC, AISC, ACI and ASCE. * Ability to use ...

Pae

Structural Engineer - Remote/Hybrid

Oak Ridge, TN · On-site +1

Sole US citizenship required (to comply with government customer requirements and/or applicable ... Experience implementing local and national codes such as IBC, AISC, ACI and ASCE. * Ability to use ...

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All JobsMedical Coder Government JobsRemote Medical Coder Government JobsRemote Medical Coder Government Jobs in Tennessee

Remote Medical Coder Government information

What is the difference between Remote Medical Coder Government vs Remote Medical Coder?

AspectRemote Medical Coder GovernmentRemote Medical Coder
CertificationsAHIMA or AAPC credentials, often with government-specific trainingAHIMA or AAPC credentials, standard coding certifications
Work EnvironmentGovernment agencies, federal or state health programsHospitals, clinics, insurance companies, private practices
Employer & Industry UsagePrimarily government health departments and programsHealthcare providers, insurance companies, billing services
Search & Comparison IntentFocus on government-specific coding roles and regulationsGeneral coding roles in healthcare settings

Remote Medical Coder Government roles typically involve working with government health programs and require knowledge of specific regulations, whereas Remote Medical Coder positions are more diverse, covering various healthcare providers and insurance companies. Both roles require similar certifications but differ mainly in employer type and work environment.

What are some common challenges faced by remote medical coders working with government healthcare programs, and how can they be managed?

Remote medical coders working with government healthcare programs often encounter frequent regulatory updates and complex billing requirements, such as those related to Medicare or Medicaid. Staying current with changing policies and maintaining compliance can be challenging in a remote environment. To manage this, it's important to participate in ongoing training, utilize official coding resources, and actively engage in virtual meetings with your team to discuss updates and clarify any ambiguities. Maintaining strong communication with supervisors and peers helps ensure accurate coding and reduces errors that could impact reimbursement.

What is a remote medical coder government?

Remote medical coder government jobs involve reviewing and assigning standardized codes to medical diagnoses, procedures, and services for government healthcare programs, such as Medicare, Medicaid, the VA, or other public health organizations. These professionals work from home, ensuring that medical records are accurately coded for billing, compliance, and data analysis. They must be familiar with government regulations and coding systems like ICD-10, CPT, and HCPCS. Strong attention to detail, confidentiality, and certification such as CPC or CCS are typically required.

What are the key skills and qualifications needed to thrive as a remote medical coder in a government setting?

To thrive as a Remote Medical Coder in a government setting, you need a solid understanding of medical terminology, coding systems (like ICD-10-CM, CPT, and HCPCS), and typically a relevant certification such as CPC or CCS. Familiarity with electronic health record (EHR) systems, government compliance regulations, and coding software is essential. Excellent attention to detail, strong analytical skills, and the ability to work independently are standout soft skills for this role. These skills ensure accurate coding, regulatory compliance, and efficient remote workflow in a highly regulated healthcare environment.
What are popular job titles related to Remote Medical Coder Government jobs in Tennessee? For Remote Medical Coder Government jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Remote Medical Coder Government jobs in Tennessee look for? The top searched job categories for Remote Medical Coder Government jobs in Tennessee are:
What cities in Tennessee are hiring for Remote Medical Coder Government jobs? Cities in Tennessee with the most Remote Medical Coder Government job openings:
Remote Medical Coder Government jobs near you

DRG Validator/Reviewer (REMOTE)

EnableComp

Franklin, TN • Remote

Full-time

Posted 15 days ago

EnableComp rating

8.7

Company rating: 8.7 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

46th of 488 rated business services

Job description

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years. 
 
Position Summary
 
The DRG Validator/Reviewer is responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities based on diagnosis and procedure coding. Working within a specialized DRG (Diagnosis-Related Group) database, DRG Reviewers utilize their technical expertise in ICD-10 coding to analyze medical records, determine coding accuracy, and make recommendations that optimize hospital reimbursement. This role requires certification as a Certified Coding Specialist (CCS) and a deep understanding of medical record documentation, clinical coding guidelines, and DRG reimbursement methodology. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.
Key Responsibilities
  • Review inpatient claims imported into the DRG database, focusing on diagnosis, procedures, grouping logic, and reimbursement accuracy.
  • Analyze weekly hospital billing files, identifying underpaid claims based on ICD-10 diagnosis and procedure codes.
  • Conduct detailed medical record reviews post-bill to determine if submitted diagnosis and procedure codes are accurate and complete.
  • Navigate medical records efficiently, targeting specific sections (e.g., discharge summary, operative reports) based on system edits and flagged items.
  • Match clinical documentation in the medical record to corresponding ICD-10 codes, ensuring DRG accuracy.
  • Identify and correct errors such as under coded or misclassified diagnoses and procedures.
  • Utilize Health ROI system edits to detect specific high-value opportunities (e.g., dialysis, occlusion, embolization, catheterization).
  • Make reimbursement improvement recommendations and submit findings for client review and approval.
  • Collaborate with leadership on case prioritization and workflow management.
  • Stay informed on coding updates, payer guidelines, and DRG changes to support accurate recommendations.
  • Analyze client reporting.
  • Identify new revenue opportunities related to all inpatient DRG related components.
  • Other duties as required.
Requirements and Qualifications
  • Associate's or bachelor's degree in health information management or related field required. (RHIT or RHIA credentialed individuals encouraged).
  • Certified Coding Specialist (CCS) certification required.
  • 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review.
  • Strong understanding of ICD-10-CM/PCS coding guidelines, DRG reimbursement methodology, and hospital billing processes.
  • Proficient in reading and interpreting clinical documentation across multiple departments (e.g., nursing, operative, radiology, pharmacy).
  • Experience working in a post-bill coding environment and familiarity with DRG grouping software and billing databases.
  • Analytical thinker with a focus on financial impact and reimbursement accuracy.
  • Comfortable navigating multiple digital platforms, EMRs, and data systems.
  • Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Special Considerations and Prerequisites
  • This role is primarily office-based or remote, depending on company policy, with extensive computer and document review work.
  • Must be comfortable working independently in a detail-oriented, data-driven environment.
  • Excellent communication and documentation skills to support client reporting and recommendations.
  • High integrity and professionalism in handling PHI and confidential information.
  • Strong collaboration and responsiveness to feedback from leadership and client partners.
  • Ability to review and analyze large volumes of medical and billing data.
  • Strong focus and attention to detail in identifying discrepancies and ensuring compliance.
  • Ability to manage high volumes of case processing with accuracy and efficiency.
  • Ability to meet deadlines and handle time-sensitive workloads in a high-volume environment.
  • Proven written and verbal communication skills.
  • Strong analytical and problem-solving skills.
  • Ability to prioritize and manage multiple competing priorities and projects concurrently.
  • Proven experience working with external clients; strong customer service skills and business acumen.
  • Timely and regular attendance.
EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.
 
EnableComp recruits, develops and retains the industry's top talent.  As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people.  We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies.  If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.
 
 Don't just take our word for it!  Hear what our people are saying:
"I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other." - Revenue Specialist
 
"I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun." - Supervisor, Operations
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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