Clinical Consultant I

Cotiviti - US; United States; Remote; USD 70,000 - 100,000; Full time

Job summary

Cotiviti, a leader in healthcare consulting, is seeking a qualified professional for a Coding Validation role. The position involves liaising with clients, providing support on coding policies, and requires an RN license along with coding certifications. This role offers competitive benefits, remote work flexibility, and opportunities for career growth.

Benefits

Generous Paid Time Off (PTO) ranging from 17 to 27 days per year

Competitive benefits package including medical, dental, and life insurance

Opportunity for career advancement

Qualifications

• Minimum 2 years of clinical experience as a Registered Nurse.
• At least 1 year in Coding Validation and claims adjudication.

Responsibilities

• Act as liaison for clinical information between teams and clients.
• Support quality assurance processes including testing.
• Review and analyze client inquiries related to Coding Validation.

Skills

Customer Service

Analytical Skills

Research Capabilities

Education

Associate or Bachelor’s degree in Nursing

Professional coder certification (CPC, CPC-H, CPC-P, or CCS-P), RHIT or RHIA certification

Tools

Microsoft Office Suite

Job description

Employer Industry: Healthcare Consulting

Why consider this job opportunity:
- Salary up to $100,000 per year
- Competitive benefits package including medical, dental, vision, disability, and life insurance
- Generous Paid Time Off (PTO) ranging from 17 to 27 days per year, plus 9 paid holidays
- Opportunity for career advancement and growth within the organization
- Work in a collaborative environment with a focus on quality and client satisfaction
- Flexibility to work remotely with a supportive team structure

What to Expect (Job Responsibilities):
- Act as a liaison for clinical information between internal teams and external clients
- Provide resources and support to clients regarding Coding Validation policies and concepts
- Review and analyze client inquiries and Change Requests related to Coding Validation
- Collaborate with internal teams to enhance client relationships and address Coding Validation issues
- Support quality assurance processes including pre and post-release testing

What is Required (Qualifications):
- Associate or Bachelor’s degree in Nursing with an active/unrestricted RN license
- Professional coder certification (CPC, CPC-H, CPC-P, or CCS-P), RHIT or RHIA certification
- Minimum of 2 years of clinical experience as a Registered Nurse
- At least 1 year of experience in Coding Validation and claims adjudication
- Proven experience in customer service or client management within a healthcare setting

How to Stand Out (Preferred Qualifications):
- Familiarity with Cotiviti systems
- Strong research capabilities and knowledge of CMS guidelines and medical payment policies
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)
- Ability to analyze complex data for customer and internal use
- Experience working with remote cross-functional product teams

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