Coding Validation Coder I

Cotiviti • Remote,

9d • $25 - $30 • Remote

About The Position

Cotiviti is hiring full-time, remote coders to conduct claims audits for appeals, checking completeness and accuracy against coding guidelines. The role is open to candidates anywhere in the continental United States and follows a traditional daytime schedule. The hire date is February 16, 2027. New hires must attend approximately 30 days of training, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time, with 100% attendance required. Experience with E&M coding and auditing is preferred.

The coder reviews provider appeals for clinical validation, applies applicable coding guidelines, uses Cotiviti applications and training resources, and works with quality assurance and other staff to address questions and feedback. The position requires accuracy and productivity in a fast-paced production environment, adherence to HIPAA and patient confidentiality requirements, and the ability to work from a dedicated, secure home workspace with high-speed internet.

Base compensation is $25.00 to $30.00 per hour, with offers based on factors including experience, education, skills, certifications, and business needs. The role is eligible for discretionary bonus consideration. Non-exempt employees are eligible for overtime pay for hours worked over 40 in a week, or as required by applicable state law.

Requirements

• High school diploma or GED.
• National medical coder certification from AAPC or AHIMA, such as CPC or CCS.
• At least 1–2 years of medical coding experience.
• CPC coding experience.
• Adherence to official coding guidelines, Coding Clinic determinations, CMS requirements, client-specific guidelines, and other regulatory compliance guidelines and mandates.
• Excellent written and verbal communication, including interpersonal skills.
• Strong knowledge of medical terminology, anatomy, and physiology.
• Organization and time-management skills.
• Ability to read medical-record documentation and extract diagnoses.
• Computer and technology literacy.
• Ability to work in a fast-paced, high-pressure production environment and meet deadlines while making efficient, accurate audit decisions.
• Flexibility to assist with emergent situations and projects.
• Ability to absorb new information quickly and learn, test, and pass off new training concepts daily.
• Ability to think logically and process sequentially with detailed accuracy and efficiency.
• Ability to assess the accuracy, neatness, and thoroughness of assigned work.
• Ability to provide a dedicated, secure work area, high-speed internet access, and office setup and maintenance.

Nice To Haves

• Experience with E&M coding and auditing.

Responsibilities

• Perform daily audits on provider appeals for completeness and accuracy under specified coding guidelines to ensure appropriate reimbursement.
• Apply client-specific coding guidelines when applicable.
• Learn new appeal categories as production needs require.
• Stay current on coding guidelines relevant to the position.
• Use Cotiviti applications to process clinical validation appeals and meet production and accuracy standards.
• Review quality feedback from QA.
• Submit questions for clarification as needed.
• Use the QA Resolution process when disagreements arise regarding a clinical validation appeal determination.
• Interact with Cotiviti staff, including training and quality assurance, to clarify or provide training on coding results.
• Communicate findings, errors, and suggestions professionally to the Team Lead to support ongoing communication and efficient operations.
• Use Cotiviti training tools and the CV library to answer questions.
• Provide teaching, mentoring, or oversight on appeal categories when requested.
• Complete responsibilities in the annual Performance Plan, special projects, and other assigned duties.
• Perform duties with or without reasonable accommodation.
• Participate in required training and comply with HIPAA and patient confidentiality requirements.

Benefits

• Medical, dental, vision, disability, and life insurance coverage.
• 401(K) savings plan.
• Paid family leave.
• 9 paid holidays per year.
• 17–27 days of paid time off per year, depending on level and length of service.
• Eligible for discretionary bonus consideration.
• Overtime pay eligibility for non-exempt employees for hours worked over 40 in a week, or as required by applicable state law.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED