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Cotiviti

Enabling a high-quality and viable healthcare system

Clinical Auditor, Outpatient Specialty

AuditorAuditorFull TimeRemoteSeniorTeam 5,001-10,000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

1 day ago

Salary

$45.6K / hour

Seniority

Senior

Associate Degree5 yrs expEnglish

Job Description

Clinical Auditor, Outpatient Specialty

Cotiviti

• Audits Outpatient and Specialty Claims • Utilizes medical chart coding principles and client specific guidelines • Performs work independently, reviews and interprets medical records • Utilizes advanced proficiency, Cotiviti encoder and audit tools • Maintains production goals, accuracy and quality standards • Identifies potential claims outside of concept for additional recoveries • Suggests, develops and implements new ideas for audit production and client satisfaction

Job Requirements

  • Associate or bachelor’s degree in nursing (active /unrestricted license)
  • Coding Certification required and maintained i.e. CPC, CIC, CCS, CCS-P, RHIA or RHIT
  • 5 to 7 years of experience with clinical medical record coding or auditing
  • Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
  • Broad knowledge of medical claims billing/payment systems provider billing guidelines
  • Adherence to official coding guidelines and coding clinic determinations
  • Requires expert coding knowledge - DRG, ICD-10, CPT, HCPCS codes
  • Excellent verbal and written communication skills
  • Ability to work well in an individual and team environment

Benefits

  • Medical, dental, vision insurance
  • Disability and 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

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