Job Title
Cotiviti has multiple openings for full-time coders. These roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule.
Responsibilities
- Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement.
- Apply client specific coding guidelines when applicable.
- Learns new appeal categories as production need requires.
- Stays current on coding guidelines appropriate to the position.
- Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards.
- Reviews quality feedback from QA.
- Submits questions for clarification as needed.
- Utilizes the 'QA Resolution' process when disagreement occurs related to a CV Appeals determination.
- Regular interaction with other Cotiviti staff, such as training and quality assurance to facilitate clarification and/or training on coding results.
- Professionally communicates finds, errors, and any suggestions to Team Lead to facilitate on-going communications and efficient department operations as part of a continuous improvement process.
- Utilize Cotiviti training tools and CV library for questions.
- Provide teaching, mentoring and or oversight on appeal categories when requested.
- Complete all responsibilities as outlined on annual Performance Plan.
- Complete all special projects and other duties as assigned.
- Must be able to perform duties with or without reasonable accommodation.
Qualifications
Education (required):
- High School Diploma or GED required.
- Nationally certified medical coder as certified by either AAPC or AHIMA. (CPC, CCS, etc.).
Experience (required):
- At least 1-2 years of medical coding experience.
- Experience in CPC coding required.
- Adherence to official coding guidelines, coding clinic determinations, CMS, Client specific guidelines and other regulatory compliance guidelines and mandates.
- Excellent written and verbal skills to include interpersonal skills.
- Strong knowledge of medical terminology and anatomy and physiology.
- Skills in organization and time management.
- Ability to read and understand medical record documentation for diagnosis extraction.
- Computer and technology literate.
- Must be able to work in a fast-paced environment.
- Ability to manage and meet deadlines.
- Must remain flexible to provide assistance in any emergent situations and/or projects.
- Must participate in any required training.
- Must abide by all HIPAA and associated patient confidentiality requirements.
Mental Requirements:
- Ability to absorb new information quickly and train in a fast-paced environment and ability to learn, test and pass off new training concepts daily.
- Ability to work in a high-pressure production environment and make audit decisions efficiently and accurately.
- Possesses excellent written and verbal communication skills.
- Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency.
- Assessing the accuracy, neatness and thoroughness of the work assigned.
Physical Requirements and Working Conditions:
- Remaining in a stationary position, often standing or sitting for prolonged periods.
- Communicating with others to exchange information.
- Repeating motions that may include the wrists, hands, and/or fingers.
- Assessing the accuracy, neatness, and thoroughness of the work assigned.
- No adverse environmental conditions expected.
- Must be able to provide a dedicated, secure work area.
- Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
Base compensation ranges from $25.00 to $29.00 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.
Non-Exempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(K) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.