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Cotiviti US & Canada Page

Auditor Clinical Validation DRG

Cotiviti US & Canada Page, Myrtle Point, Oregon, United States, 97458

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Why consider this job opportunity

Salary up to $45.67 per hour (approximately $95,000 annually)

Eligible for discretionary bonus consideration

Comprehensive benefits package, including medical, dental, vision, disability, and life insurance

Paid family leave and 9 paid holidays per year

Generous Paid Time Off (PTO) ranging from 17 to 27 days per year, depending on tenure

Flexible remote work opportunity

What to Expect (Job Responsibilities)

Analyze and audit claims using medical chart coding principles and clinical guidelines

Utilize proprietary auditing systems to make determinations and generate audit letters

Maintain production and accuracy goals set by the audit operations management team

Identify potential claims for additional recoveries and suggest process improvements

Complete special projects and other duties as assigned

What is Required (Qualifications)

Associate or bachelor’s degree in nursing with an active/unrestricted license, or in Health Information Management (RHIA or RHIT), or a high school diploma/GED with 5+ years of relevant experience

Coding/CDI certification (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required and must be maintained

5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG

Expert knowledge of coding guidelines and compliance regulations

Proficiency in Microsoft Word, Access, Excel, TEAMS, and excellent communication skills

How to Stand Out (Preferred Qualifications)

Experience in claims auditing, quality assurance, or recovery auditing in a DRG/Clinical Validation Audit setting or hospital environment

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