Cotiviti · 19 hours ago
Clinical Analyst I
United States
Full-time
Remote
Entry Level
$34/hr - $38/hr
2+ years expCotiviti is a healthcare analytics company seeking a Clinical Analyst I to perform daily audits on client data for coding accuracy and completeness. The role involves responding to provider appeals and contributing feedback to management to enhance efficiency, all while meeting strict performance indicators in a fast-paced environment.
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
Qualification
Required
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
Required to obtain NY Independent Insurance Adjuster licensure within the first four months
Strong working knowledge of medical procedures, conditions, illnesses, and treatment practices
Has excellent personal computer skills in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
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
Preferred
Coding Certification Preferred (Outpatient - CPC, CCS or CCS-P) or required to obtain within 1st year of employment
Benefits
Medical
Dental
Vision
Disability
Life insurance coverage
401(K) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.
Company
Cotiviti
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Adam Gilbert
Director, Interoperability Operations and Partnerships
Chris McIntyre
Sr. Program Manager, RQNC Operations
Recent News
2024-04-07
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