Auditor Technical Trainer – DRG

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $105k - $125k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Assess job-specific needs and develop technical training plans with clear business objectives • Deliver specific training sessions using suitable delivery methods such as classroom, online, and webinar • Provide support to the CCV audit team members; assist with orientation of new members as needed, mentor new team members after orientation • Promote audit accuracy measures by training/educating and mentoring the auditor and providing documented and validated findings • Provide training on one or more of the following audit types: Outpatient and Specialty Review Types to include SNF, IRF, and HH • Monitor/Assess the performance of self, other individuals, &/or organizations to make improvements or recommend remediation or corrective action

🎯 Requirements

• Associates Degree or equivalent relevant experience required • 5 to 7+ years of working with a broad knowledge of medical claims, billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology • Clinical /Nursing experience in an SNF, IRF, and HH setting is required • Coding certification is required and maintained as a condition of employment (CCS, CPC, etc.) • Adherence to official coding guidelines, coding clinic determinations, and CMS and other regulatory compliance guidelines and mandates • Requires expert coding knowledge - CPT and HCPCS codes • Strong presentation skills • Independent thinker, logical, strategic, with a high focus and attention to detail • High level of proficiency with all audit technology i.e., R3, CAT, etc. • Proficiency in Word, Access, Excel, PowerPoint and other applications • Applicants should have home health, IRF, and SNF experience.

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Disability insurance • 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 service