Cotiviti - US

Auditor Clinical Validation DRG


PayCompetitive
LocationRemote
Employment typeOther

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  • Job Description

      Req#: 15396
      Employer Industry: Healthcare Auditing

      Why consider this job opportunity:
      - Salary up to $45.67 per hour (approximately $95,000 annualized)
      - Eligible for discretionary bonus consideration
      - Comprehensive benefits package, including medical, dental, vision, disability, and life insurance
      - Generous Paid Time Off (PTO) ranging from 17-27 days per year
      - Opportunity for career advancement within a leading healthcare auditing organization
      - Flexible remote work option available

      What to Expect (Job Responsibilities):
      - Analyze and audit inpatient claims, ensuring compliance with coding principles and clinical guidelines
      - Utilize proprietary auditing systems to make determinations and generate audit letters
      - Maintain productivity and accuracy standards set by the audit operations management team
      - Identify new claim types and suggest process improvements for better recovery outcomes
      - Complete special projects and other duties as assigned, adhering to performance plans

      What is Required (Qualifications):
      - Associate or bachelor’s degree in nursing (active/unrestricted license) or Health Information Management (RHIA or RHIT)
      - Coding/CDI certification (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required
      - 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
      - Expert knowledge of coding guidelines, compliance mandates, and medical claims billing/payment systems
      - Proficiency in Word, Access, Excel, TEAMS, and other relevant applications

      How to Stand Out (Preferred Qualifications):
      - Strong written and verbal communication skills
      - Experience adhering to official coding guidelines and regulatory compliance

      #HealthcareAuditing #RemoteWork #CareerOpportunity #CompetitivePay #BenefitsPackage
  • About the company

      Cotiviti is a solutions and analytics company leveraging unparalleled clinical and financial datasets to deliver insight into the healthcare system’s performance.

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