Coder 2

Cotiviti drives better healthcare outcomes through data analytics. Our payment accuracy, revenue integrity, risk assessment and stratification, and quality improvement solutions help organizations utilize their data so they can efficiently and cost-effectively succeed in the new era of healthcare.

We are currently looking for multiple Remote Risk Adjustment / HCC Coders (Coder 2) for full-time permanent positions.

See what it's like to work as a Coder at Cotiviti:
https://www.youtube.com/watch?v=-VgcV09cxCo

Reviews records for accurate, compliant, and complete diagnosis code abstraction for Medicare, Commercial and Medicaid risk adjustment from various chart types (physician, facility, and non-facility).
• May have special projects that will entail a coding audit.

• Codes following the ICD-10-CM Official Guidelines for Coding and Reporting, AHA's Coding Clinic and well as Cotiviti and client specific coding guidelines.

• Utilizes the 'Dispute Resolution' process when disagreement occurs related to a coding determination.

• Stays current on coding guidelines necessary for the position by attending all Cotiviti required trainings, workshops, and personal research as appropriate.

• Professionally communicates finds, errors, and suggestions to Team Lead to facilitate on-going communications and efficient department operations as part of a continuous improvement process.

• Reports concerns or issues identified to the appropriate QA I (based on the first pass coder) and/or management as needed.

• Assist with mentoring new Risk Adjustment Coders under direction of training team in learning the rules, guidelines of coding and the application of Cotiviti policies and procedures for appeals review.

• Complete all responsibilities as outlined in the annual performance review and/or goal setting. Required.
• Complete all special projects and other duties as assigned. Required.
• Must be able to perform duties with or without reasonable accommodation. Required.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change. Required.

• Must have more than 2 years of medical risk adjustment coding experience.
• Nationally certified medical coder as certified by either AAPC or AHIMA (CRC, CPC, CCS, etc.
• Maintains professional credential in good standing as required by AAPC and/or AHIMA.
• Experience in HCC record abstraction and coding requirements.
• Minimum High School Diploma.
• Demonstrated high level of quality accuracy and productivity in clinical coding work.
• Adherence to official coding guidelines (including coding clinics, CMS, client specific guidelines and other regulatory compliance guidelines and mandates).
• Strong knowledge of medical terminology and anatomy and physiology.
• Advanced skills and knowledge of computers with the ability to use the designated coding platform for coding processes with focus on both production and accuracy.
• Skills in organization and time management.
• Ability to read and understand medical record documentation for diagnosis extraction.
• Comfortable with computers and technology.
• Must abide by all HIPAA and associated patient confidentiality requirements.

Mental Requirements:

• Excellent written and communication skills with the ability to understand and explain complex information.
• Ability to regularly and consistently achieve over 95% quality accuracy.

• Appropriately communicate with management regarding workload, production expectations and deliverables.

• Quick learner with the ability to manage multiple priority projects simultaneously while remaining positive.
• Must be able to work in a fast-paced environment.
• Ability to manage and meet deadlines.
• Adaptability to changing priorities, flexible and open to new ideas.

Physical Requirements and Working Conditions:

• Must participate in all required training.
• 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.
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands and/or fingers.
• Required hours for training: Monday-Friday 8 AM - 5 PM ET
• Required working hours: 40 hours per week, Monday-Friday 8-hour days; daytime schedule only based on your time zone. This role is not intended to work nights, weekends or part-time.

Base compensation ranges from $21.00 to $27.00 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.

Nonexempt 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. For information about our benefits package, please refer to our careers page at Healthcare Analytics Careers | Cotiviti.

Date of posting: 3/18/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 4/30/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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