Senior Auditor, Quality

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $47 - $56 / hour

⏰ Full Time

🟠 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

• Ensuring audited claims meet quality standards • Communicating with initial auditors to ensure accuracy • Performing clinical quality assurance review • Utilizing industry knowledge for medical audit activities • Reviewing medical records for billing/coding issues • Mentoring QA auditors or initial auditors • Flexing into initial audit role as needed

🎯 Requirements

• Associates or Bachelor's degree in Nursing (active/unrestricted license) • Equivalent experience of 5+ years in claims auditing, quality assurance, or recovery auditing • Coding Certification (RHIA, RHIT; CCS or CIC preferred) • 3-5 years of healthcare auditing or related experience • Ability to mentor staff • Excellent verbal and written communication skills • Computer proficiency in Microsoft office suite required (Excel, Outlook, PowerPoint, SharePoint, etc.)

🏖️ Benefits

• Medical, dental, and vision coverage • Disability and life insurance • 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