• Job Description

  Req#: 17096
  Employer Industry: Healthcare Auditing
  
  Why consider this job opportunity:
  - Salary up to $45.67 per hour ($95,000 annualized)
  - Eligible for discretionary bonus consideration
  - Comprehensive benefits package including medical, dental, vision, disability, and life insurance coverage
  - 401(k) savings plans and paid family leave
  - Generous Paid Time Off (PTO) policy with 17-27 days per year based on service
  - Opportunity for professional growth within a well-established organization
  
  What to Expect (Job Responsibilities):
  - Analyze and audit claims by integrating medical chart severity of illness and intensity of service based on clinical guidelines
  - Utilize proprietary auditing systems to make audit determinations and generate audit letters
  - Maintain productivity goals set by the audit operations management team
  - Achieve expected levels of accuracy and quality for valid claim identification and documentation
  - Identify potential claims outside of the concept for additional recoveries and suggest process improvements
  
  What is Required (Qualifications):
  - Associate or Bachelor's degree in nursing
  - Active/unrestricted RN License in state of residence
  - 5 to 7+ years of experience with InterQual/MCG (Inpatient vs Observation) and in Utilization Management or Case Management
  - Critical Care background (ICU, Emergency Room, Cath Lab, Med Surg)
  - Proficiency in Microsoft Word, Access, Excel, TEAMS, and excellent written and verbal communication skills
  
  How to Stand Out (Preferred Qualifications):
  - Case Management Certification
  - Experience in a dedicated healthcare auditing role
  - Familiarity with industry-based standards and guidelines
  
  #HealthcareAuditing #NursingJobs #CareerOpportunity #CompetitivePay #ProfessionalGrowth
  
  We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
  We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.

• 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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