Cotiviti - US
Auditor Clinical Validation DRG
What's your preference?
Job Description
- Req#: 16451
Employer Industry: Healthcare Auditing
Why consider this job opportunity:
- Salary up to $45.67 per hour (approximately $95,000 annually)
- Eligible for discretionary bonus consideration
- Comprehensive benefits package, including medical, dental, vision, disability, and life insurance
- Paid family leave and 9 paid holidays per year
- Generous Paid Time Off (PTO) ranging from 17 to 27 days per year, depending on tenure
- Flexible remote work opportunity
What to Expect (Job Responsibilities):
- Analyze and audit claims using medical chart coding principles and clinical guidelines
- Utilize proprietary auditing systems to make determinations and generate audit letters
- Maintain production and accuracy goals set by the audit operations management team
- Identify potential claims for additional recoveries and suggest process improvements
- Complete special projects and other duties as assigned
What is Required (Qualifications):
- Associate or bachelor’s degree in nursing with an active/unrestricted license, or in Health Information Management (RHIA or RHIT), or a high school diploma/GED with 5+ years of relevant experience
- Coding/CDI certification (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required and must be maintained
- 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
- Expert knowledge of coding guidelines and compliance regulations
- Proficiency in Microsoft Word, Access, Excel, TEAMS, and excellent communication skills
How to Stand Out (Preferred Qualifications):
- Experience in claims auditing, quality assurance, or recovery auditing in a DRG/Clinical Validation Audit setting or hospital environment
#HealthcareAuditing #RemoteWork #CompetitiveSalary #CareerGrowth #BenefitsPackageAbout the company
Cotiviti is a solutions and analytics company leveraging unparalleled clinical and financial datasets to deliver insight into the healthcare system’s performance.
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.