Cotiviti · 7 hours ago
Coding Validation Coder I
United States
Full-time
Remote
Entry Level
$22/hr - $29/hr
1+ years expCotiviti is a healthcare analytics company seeking multiple full-time Coding Validation Coders. The role focuses on performing claims audits for appeals, ensuring completeness and accuracy based on coding guidelines, and requires interaction with various staff for training and clarification.
Responsibilities
Clinical Validation - Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement
Apply client specific coding guidelines when applicable
Learns new appeal categories as production need requires
Stays current on coding guidelines appropriate to the position
Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards
Reviews quality feedback from QA
Submits questions for clarification as needed
Utilizes the ‘QA Resolution’ process when disagreement occurs related to a CV Appeals determination
Regular interaction with other Cotiviti staff, such as training and quality assurance to facilitate clarification and/or training on coding results
Professionally communicates finds, errors, and any suggestions to Team Lead to facilitate on-going communications and efficient department operations as part of a continuous improvement process
Utilize Cotiviti training tools and CV library for questions
Provide teaching, mentoring and or oversight on appeal categories when requested
Complete all responsibilities as outlined on annual Performance Plan
Complete all special projects and other duties as assigned
Must be able to perform duties with or without reasonable accommodation
Qualification
Required
High School Diploma or GED required
Nationally certified medical coder as certified by either AAPC or AHIMA. (CPC, CCS, etc.)
At least 1-2 years of medical coding experience
Experience in CPC coding required
Adherence to official coding guidelines, coding clinic determinations, CMS, Client specific guidelines and other regulatory compliance guidelines and mandates
Excellent written and verbal skills to include interpersonal skills
Strong knowledge of medical terminology and anatomy and physiology
Skills in organization and time management
Ability to read and understand medical record documentation for diagnosis extraction
Computer and technology literate
Must be able to work in a fast-paced environment
Ability to manage and meet deadlines
Must remain flexible to provide assistance in any emergent situations and/or projects
Must participate in any required training
Must abide by all HIPAA and associated patient confidentiality requirements
Ability to absorb new information quickly and train in a fast-paced environment and ability to learn, test and pass off new training concepts daily
Ability to work in a high-pressure production environment and make audit decisions efficiently and accurately
Possesses excellent written and verbal communication skills
Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency
Assessing the accuracy, neatness and thoroughness of the work assigned
Remaining in a stationary position, often standing or sitting for prolonged periods
Communicating with others to exchange information
Repeating motions that may include the wrists, hands, and/or fingers
Assessing the accuracy, neatness, and thoroughness of the work assigned
Must be able to provide a dedicated, secure work area
Must be able to provide high-speed internet access/connectivity and office setup and maintenance
Preferred
Experience with E&M coding & auditing is preferred
Benefits
Medical
Dental
Vision
Disability
Life insurance coverage
401(K) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti
Company
Cotiviti
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States.
5001-10000 employees
H1B Sponsorship
Cotiviti has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (165)
2024 (118)
2023 (90)
2022 (102)
2021 (72)
2020 (67)
Funding
Current Stage
Late StageLeadership Team
Adam Gilbert
Director, Interoperability Operations and Partnerships
Chris McIntyre
Sr. Program Manager, RQNC Operations
Recent News
2024-04-07
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