Category | Audit - Healthcare | Position Type | Full-Time |
As a Concept Development Analyst (CDA) within the Clinical Chart Validation team, you'll spearhead the identification, creation, and implementation of inpatient claim selection rules focusing on the payment integrity of the billed DRG. Leveraging your industry experience and deep knowledge of inpatient coding practices, APR-DRG methodologies, and billing regulations, you'll craft innovative strategies to enhance claim selection processes, contributing directly to payment integrity for our clients.
Your data analysis expertise, strong organizational skills, and comprehensive understanding of claim selection methods will be instrumental in innovating and optimizing proprietary tools that uphold the highest standards of payment accuracy. You'll work closely with senior team members, playing a pivotal role in refining and executing methodologies that elevate our claim selection strategies focused on inpatient claims.
This position involves research, development, implementation, and maintenance of new audit opportunities, with a primary focus on DRG validation prior to the claim being paid. As a CDA, you'll be responsible for monitoring query outputs, tracking audit performance outcomes, and investigating discrepancies or variances, ensuring consistent alignment with our team's objectives and the evolving needs of the healthcare billing landscape.
We are seeking candidates with a proven track record of possessing strong analytical and research skills. The ideal candidate should demonstrate the ability to critically analyze information, think logically, and draw meaningful insights from data. Additionally, a keen attention to detail and the capacity to conduct thorough research to gather relevant information are paramount.
Candidate should be self-motivated and capable of working independently, demonstrating the ability to make sound decisions autonomously when necessary.
Working Conditions and Physical Requirements:
Must be able to provide high-speed internet access / connectivity and office setup and maintenance.
Base compensation ranges from $88,000 to $110,000. 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.
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.
Date of posting: 5/9/2024
Applications are assessed on a rolling basis. We anticipate that the application window will close on 7/9/2024, 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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