Auditor Clinical Validation Outpatient Specialty Clinical
Remote regions
USBenefits
3w PTO
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Key Responsibilities:
- Conduct clinical and coding audits on outpatient and specialty claims, adhering to CMS and client guidelines.
- Use Cotiviti encoder and audit tools to evaluate medical records for billing and coding accuracy.
- Identify potential new claim types and recommend process improvements to enhance audit production.
Qualifications:
- Associate or Bachelor's in Nursing with active/unrestricted license and coding certification (CPC, CIC, CCS, etc.).
- 5-7 years of clinical coding or auditing experience with HIPAA and CMS knowledge.
- Expert proficiency in DRG, ICD-10, CPT, and HCPCS coding systems.
Compensation and Benefits:
- Hourly base pay of $45.67 (annualized at $95k) with discretionary bonus eligibility.
- Comprehensive benefits including medical, dental, vision, disability, life insurance, and 401(k).
- Paid family leave, 9 holidays, and 17-27 days of PTO per year based on experience.
Cotiviti
Cotiviti is a healthcare analytics and auditing company that focuses on improving claims accuracy and reducing costs for clients. They are a mid-to-large sized employer with a culture that emphasizes quality, collaboration, and innovation in healthcare auditing.