Coding Validation Coder I

Overview Cotiviti has multiple openings for full-time coders....these roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & 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 1/18/2027 and you will be expected to attend training Monday-Friday from 9-5 ET. Training will last about 30 days. 100% attendance is required. 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 de