Cotiviti

Cotiviti is seeking Remote Risk Adjustment / HCC Coders for full-time permanent roles. The coder conducts diagnosis code abstraction for Medicare, Commercial, and Medicaid programs, applying ICD-10-CM guidelines and Cotiviti/client requirements to ensure high-quality outcomes. Responsibilities include reviewing records, staying current with guidelines, and communicating findings to Team Lead. Training is 8 AM–5 PM ET; 40 hours weekly, remote work across time zones. #J-18808-Ljbffr

Overview The Content Solutions Analyst I is a key member of the clinical operations and content team responsible for the research, quality assurance, and opportunity analysis associated with new medical policies. In addition, this position will be responsible for review and analysis of current medical policies and assisting in the research necessary to define additional logic and algorithms to expand the Cotiviti payment policy library. The Content Solutions team works within Payment Policy Management and supports all of our PPM Solutions: outpatient, inpatient, genetics, pharmacy, fraud, and dental. This role is intended to work within our Genetics/Lab Content Team and we are looking for an experienced certified lab coder to support medical policy & edit development. There is no expectation, if hired, that you will align with only one solution and you should be prepared to work in all of our solutions. Responsibilities Familiarity with claims payment and reimbursement...