Lead Inpatient Clinical Validation Auditor

Cotiviti; United States; Remote; USD 85,500 - 104,500; Full time

Benefits offered by this job

Medical, dental, vision, and life insurance

401(k) savings plan

Paid family leave

Generous Paid Time Off (PTO)

Job summary

Cotiviti is seeking an Auditing professional to focus on Coding & Clinical Chart Validation for inpatient audits. Applicants should have a strong nursing background alongside coding/auditing expertise within Inpatient DRG/APR-DRG disciplines.

The role requires analyzing inpatient claims, ensuring coding accuracy, and documenting audit results. Competitive compensation of $45.67 per hour with eligibility for bonuses is offered, along with a full benefits package.

Qualifications

• 5+ years in claims auditing, quality assurance, or recovery auditing.
• Certified in RHIA, RHIT, CPC, or CCS, CIC, CDIP, or CCDS.
• Proficient in coding terminology and regulatory compliance.

Responsibilities

• Analyze and audit claims utilizing medical coding principles.
• Utilize Cotiviti audit tools for determinations.
• Document findings clearly and maintain productivity standards.

Skills

ICD-9/10CM

Medical claims billing

Coding guidelines adherence

Microsoft Office Suite

Excellent communication

Education

Bachelor's degree in nursing or Health Information Management

High school diploma plus 5+ years relevant experience

Tools

Word

Access

Excel

Teams

Job description

Cotiviti is seeking an Auditing professional to focus on Coding & Clinical Chart Validation for inpatient audits. Applicants should have a strong nursing background alongside coding/auditing expertise within Inpatient DRG/APR-DRG disciplines.

The role requires analyzing inpatient claims, ensuring coding accuracy, and documenting audit results. Competitive compensation of $45.67 per hour with eligibility for bonuses is offered, along with a full benefits package.