[Remote] Associate Auditor Clinical Validation DRG

Note: The job is a remote job and is open to candidates in USA. Cotiviti is a healthcare auditing company seeking an Associate Auditor for Clinical Validation in DRG. The role involves auditing inpatient claims, ensuring coding accuracy, and performing clinical chart validation while using proprietary auditing tools.

Responsibilities

• Analyzes and Audits Claims
• Effectively Utilizes Audit Tools
• Meets or Exceeds Standards/Guidelines for Productivity
• Meets or Exceed Standards/Guidelines for Accuracy and Quality
• Identifies New Claim Types
• Complete all responsibilities as outlined in the annual performance review and/or goal setting
• Complete all special projects and other duties as assigned
• Must be able to perform duties with or without reasonable accommodation

Skills

• Associate or bachelor's degree in nursing (active /unrestricted license)
• Associate or bachelor's degree Health Information Management (RHIA or RHIT)
• Licensed Practical Nurse (LPN) (active /unrestricted license)
• RHIA or RHIT certification
• CPC or COC certification
• Inpatient Coding Credential – CCS, CIC, CDIP or CCDS
• 2 years of prior clinical and/or coding experience
• Basic to Intermediate knowledge of medical and coding terminology
• Working knowledge of medical claims billing/payment systems and provider billing guidelines
• Requires working knowledge of and applicable industry-based standards
• Proficiency in Word, Access, Excel, TEAMS, and other applications
• Excellent written and verbal communication skills
• 2 years of prior clinical and/or coding experience is preferred
• Working knowledge of medical claims billing/payment systems and provider billing guidelines 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

Company Overview

Company H1B Sponsorship