Medical Claims Auditor (Fully Remote)

Clover Health; United States; Remoto; USD 65.000 - 95.000; Tempo pieno

Vantaggi offerti da questo lavoro

Equity

Bonus

401k

Flexible time off

Medical, dental, vision

Parental leave

Remote-first culture

Descrizione del lavoro

Clover Health is hiring a CPC with 3+ years of coding and auditing experience to review claims for billing and coding issues in collaboration with SIU and Clinical teams. The role leverages AI tools to flag anomalous patterns and support prepayment audits.

The ideal candidate has strong CMS/CCI knowledge and Medicare coding expertise. This is a remote-first opportunity with competitive compensation and benefits from a fast-growing, mission-driven company.

Competenze

• 3+ years of coding and auditing experience.
• Strong knowledge of CMS regulations, CCI, and Medicare coding.
• Experience working with SIU and clinical teams is a plus.

Mansioni

• Review claims for billing and coding issues with SIU and Clinical teams.
• Use AI tools to identify anomalous billing patterns and support prepayment audits.

Conoscenze

Claims auditing

CMS regulations knowledge

Medicare coding

CPC certification

Formazione

CPC Certification

Descrizione del lavoro

• Review claims for billing and coding issues with SIU and Clinical teams.
• Use AI tools to identify anomalous billing patterns and support prepayment audits.

Who you are:

• CPC with 3+ years of coding and auditing experience.
• Strong knowledge of CMS regulations, CCI, and Medicare coding.

What we offer:

• Competitive salary, equity, bonus, 401k, and flexible time off.
• Medical, dental, vision, parental leave, and remote-first culture.

Clover Health

Clover Health is reinventing health insurance by combining the power of data with human empathy to keep members healthier. It is a fast-growing, remote-first startup with a mission-driven, collaborative culture focused on improving healthcare.