Auditor, Clinical Validation, OPSP Coding

Cotiviti

Auditor handling Coding & Clinical Chart Validation for Outpatient and Specialty audits at Cotiviti. Requires strong clinical and coding auditing background with detailed responsibility for claims review.

Posted 5/21/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $95,600 per hourWebsite

About the role

Key responsibilities & impact

Focus on auditing Coding & Clinical Chart Validation for Outpatient and Specialty audits
Audits Outpatient and Specialty Claims using medical chart coding principles
Utilizes advanced proficiency in Cotiviti encoder and audit tools for duties
Maintains productivity, accuracy, and quality standards for auditing
Identifies potential claims for additional recoveries and suggests process improvements
Completes all responsibilities outlined in the annual Performance Plan

Requirements

What you’ll need

Associate or bachelor’s degree in Health Information Management (RHIA or RHIT)
Coding Certification required and maintained (e.g., CPC, CIC, CCS, CCS-P, RHIA or RHIT)
5 to 7 years of experience with clinical medical record coding or auditing
Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
Broad knowledge of medical claims billing/payment systems and provider billing guidelines
Adherence to official coding guidelines and CMS regulatory compliance

Benefits

Comp & perks

Health insurance
401(k) matching
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical chart codingauditingcoding principlesclaims auditingprocess improvementscoding guidelinesmedical record coding

Soft Skills

productivityaccuracyquality standardssuggesting improvements

Certifications

CPCCICCCSCCS-PRHIARHIT