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Coding Validation Coder I

COTIVITI, INC.

SOUTH JORDAN, UT

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JOB DETAILS
SKILLS
Anatomy, Auditing, Certified Coding Specialist (CCS), Clinical Validation, Content Management Systems (CMS), Continuous Improvement, Documentation, HIPAA (Health Insurance Portability and Accountability Act), Interpersonal Skills, Medical Coding, Medical Records, Medical Terminology, Mentoring, Operational Strategy, Patient Confidentiality, Physiology, Presentation/Verbal Skills, Production Systems, Quality Assurance, Quality Assurance Methodology, Regulatory Compliance, Reimbursement, Team Lead/Manager, Time Management, Training Tools, Training/Teaching, Writing Skills
LOCATION
SOUTH JORDAN, UT
POSTED
2 days ago
Coding Validation Coder I Job Locations   US-Remote ID   2026-19206         Category  Coding     Position Type  Full-Time Overview   Cotiviti has multiple openings for full-time coders....these roles will focus on claims audits for appeals, checking for completeness and accuracy based on coding guidelines. Experience with EandM coding and auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule. The hire date for this position will be 7/20/2026 and you will be expected to attend training Monday-Friday from 9-5 ET.  Training will last about 90 days and time off will be limited during this time.            Responsibilities   Clinical Validation - Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement. * Apply client specific coding guidelines when applicable. * Learns new appeal categories as production need requires. * Stays current on coding guidelines appropriate to the position. * Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards. * Reviews quality feedback from QA. * Submits questions for clarification as needed. * Utilizes the 'QA Resolution' process when disagreement occurs related to a CV Appeals determination. * Regular interaction with other Cotiviti staff, such as training and quality assurance to facilitate clarification and/or training on coding results. * Professionally communicates finds, errors, and any suggestions to Team Lead to facilitate on-going communications and efficient department operations as part of a continuous improvement process. * Utilize Cotiviti training tools and CV library for questions. * Provide teaching, mentoring and or oversight on appeal categories when requested. * Complete all responsibilities as outlined on annual Performance Plan. * Complete all special projects and other duties as assigned. * Must be able to perform duties with or without reasonable accommodation. 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.             Qualifications   Education (required): * High School Diploma or GED required. * Nationally certified medical coder as certified by either AAPC or AHIMA. (CPC, CCS, etc.). Experience (required): * At least 1-2 years of medical coding experience. * Experience in CPC coding required. * Adherence to official coding guidelines, coding clinic determinations, CMS, Client specific guidelines and other regulatory compliance guidelines and mandates. * Excellent written and verbal skills to include interpersonal skills. * Strong knowledge of medical terminology and anatomy and physiology. * Skills in organization and time management. * Ability to read and understand medical record documentation for diagnosis extraction. * Computer and technology literate. * Must be able to work in a fast-paced environment. * Ability to manage and meet deadlines. * Must remain flexible to provide assistance in any emergent situations and/or projects. * Must participa te in any required training. * Must abide by all HIPAA and associated patient confidentiality requirements. Mental Requirements: * 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... For full info follow application li k.   Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

About the Company

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COTIVITI, INC.