Remote Medical Coding Auditor – Appeals Validation

Cotiviti; United States; A distancia; USD 34.000 - 41.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

401(k)

Paid family leave

Holidays

Paid time off

Descripción de la vacante

Cotiviti is hiring full-time remote medical coders in the United States to perform claims audits for appeals, focusing on completeness and accuracy per coding guidelines. Training runs 9-5 ET for about 30 days with 100% attendance required, starting 1/18/2027.

Roles require CPC coding certification, 1–2 years of experience, and strong knowledge of medical terminology. Benefits include a comprehensive package with health coverage, 401(k), and PTO.

Formación

• High School Diploma or GED required.
• Nationally certified medical coder (CPC/CCS) through AAPC or AHIMA.
• 1–2 years of medical coding experience.
• Experience in CPC coding required.
• Adherence to official coding guidelines and regulatory compliance.
• Excellent written and verbal skills.
• Strong knowledge of medical terminology and anatomy.
• Ability to read medical records for diagnosis extraction.
• Computer and technology literate.
• Able to work in a fast-paced environment and meet deadlines.
• Must comply with HIPAA and confidentiality requirements.

Responsabilidades

• Perform daily audits on provider appeals for completeness and accuracy based on coding guidelines.
• Apply client-specific coding guidelines when applicable.
• Learn new appeal categories as production needs require.
• Stay current on coding guidelines relevant to the position.
• Use Cotiviti applications to process CV appeals to meet production and accuracy standards.
• Review QA feedback and act on it.
• Submit questions for clarification as needed.
• Use the QA Resolution process for disagreements on CV appeals determinations.
• Interact with training and QA staff for clarification and training on coding results.
• Communicate findings, errors, and suggestions to Team Lead as part of continuous improvement.
• Utilize Cotiviti training tools and CV library for questions.
• Provide teaching, mentoring, or oversight on appeal categories when requested.
• Complete all responsibilities per annual Performance Plan and any special projects.

Conocimientos

Medical coding

CPC coding

Interpersonal skills

Written and verbal communication

Time management

HIPAA compliance

Attention to detail

Medical terminology

Computer literacy

Educación

High School Diploma or GED

Nationally certified medical coder (AAPC/AHIMA CPC/CCS)

Descripción del empleo

Cotiviti is hiring full-time remote medical coders in the United States to perform claims audits for appeals, focusing on completeness and accuracy per coding guidelines. Training runs 9-5 ET for about 30 days with 100% attendance required, starting 1/18/2027.

Roles require CPC coding certification, 1–2 years of experience, and strong knowledge of medical terminology. Benefits include a comprehensive package with health coverage, 401(k), and PTO.