Cotiviti logo
Cotiviti

Founded in 1979, Cotiviti provides analytics-driven payment and network solutions for the healthcare and retail industries, offering services that help payers, risk-bearing healthc

Auditor, Technical Trainer – POS

Location

United States

Posted

8 days ago

Salary

$105K - $125K / year

Seniority

Senior

Associate Degree5 yrs expEnglish

Job Description

Auditor, Technical Trainer – POS

Cotiviti

• Assess job-specific needs and develop technical training plans with clear business objectives • Select training/instructional methods and procedures appropriate for the situation • Deliver specific training sessions, including using suitable delivery methods such as classroom, online, and webinar • Identify the development needs of others and coach, mentor, or otherwise assist others with improving their knowledge skills • Provide support to the CCV audit team members; assist with orientation of new members as needed • Promote audit accuracy measures by training/educating and mentoring the auditor and providing documented and validated findings • Conduct or arrange for ongoing technical training and personal development classes for staff members • Integrate healthcare auditing principles and use objectivity in the performance of medical audit activities and reviews • Provide feedback on reviews to the Quality Assurance Manager as indicated

Job Requirements

  • Associate or Bachelor's degree in nursing
  • RN License (active/unrestricted in state of residence)
  • Case Management Certification (preferred, but not required)
  • 5 to 7+ years of working with InterQual/MCG (Inpatient vs Observation)
  • Background in Utilization Management and/or Case Management
  • Critical Care background: ICU, Emergency Room, Cath Lab, Med Surg
  • 5 to 7+ years of working with a broad knowledge of medical claims, billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology
  • Requires expert level knowledge of Interqual and/or MCG criteria
  • Strong presentation skills
  • Independent thinker, logical, strategic, with a high focus and attention to detail
  • Effective communication and presentation style (written and verbal) with proven ability to positively influence behavior and outcomes
  • Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects
  • Competent administrative and organizational skills, ability to multitask, set priorities, and meet deadlines
  • High level of proficiency with all audit technology i.e., R3, CAT, etc.
  • Proficiency in Word, Access, Excel, PowerPoint and other applications
  • Excellent written and verbal communication skills

Benefits

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Disability insurance
  • Life insurance
  • 401(k) savings plans
  • Paid family leave
  • 9 paid holidays per year
  • 17-27 days of Paid Time Off (PTO) per year

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