Remote Coding Validation Analyst I - Audits & Appeals

Cotiviti; Idaho; On-site; USD 46,838 - 52,348; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) savings plan

Paid holidays

Paid time off (PTO)

Job summary

Cotiviti is seeking a Coding Validation Analyst I to perform daily audits on client data for completeness and accuracy of coding, using clinical knowledge to ensure proper reimbursement and respond to provider appeals.

This is a remote, shift-based role across MT and ET time zones with after-training rotating weekends and holidays; training lasts about 17 weeks, with a base hourly rate of $34.00–$38.00 plus eligible discretionary bonuses and a comprehensive benefits package.

Qualifications

• Active professional license as a Registered Nurse in your current state of residence (BSN preferred).
• 2 years of professional experience in providing direct patient care.
• Coding Certification Preferred (Outpatient - CPC, CCS or CCS-P) or required to obtain within 1st year of employment.
• Required to obtain NY Independent Insurance Adjuster licensure within the first four months.
• Training for this position lasts approximately 17 weeks and can be completed remotely.
• Targeted start date is October 11, 2026; hours during training are 7 AM - 3 PM MT (9 am-5 pm ET) Monday-Friday...after training you will need to be able to work a scheduled shift, that will vary. Shifts include (after training): first, second and third shifts MT with rotating weekends and holidays. Each employee should plan on working rotating weekends and holidays, and that may include early mornings, evenings, nights, weekends, and rotating holidays (everyone is required to be flexible). This group of new hires will have weekends included in their shifts.

Responsibilities

• Perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement and meet required client turnaround time and KPI goals.
• Respond to provider appeals and meet required client turnaround time and KPI goals.
• Contribute to product by providing feedback to Management/Development Teams on changes to enhance editing and efficiency.
• Utilize Coding Validation specific training to Become familiar with claims payment policy and processing – specifically CMS, Medicaid regulations, AAOS, ICD-10, CPT & HCPCS, etc.
• 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

Organizational skills

Written and verbal communication

Working under pressure

Detail-oriented

Education

Bachelor of Science in Nursing

Registered Nurse license

Tools

Microsoft Office Suite

Job description

Cotiviti is seeking a Coding Validation Analyst I to perform daily audits on client data for completeness and accuracy of coding, using clinical knowledge to ensure proper reimbursement and respond to provider appeals.

This is a remote, shift-based role across MT and ET time zones with after-training rotating weekends and holidays; training lasts about 17 weeks, with a base hourly rate of $34.00–$38.00 plus eligible discretionary bonuses and a comprehensive benefits package.