Cohere Health
Senior Claims Auditor - DRG
United States · Senior
Sponsorship not specified$74k-$90kDetected 5 days ago
ComplianceAuditingRecruitingHIPAAICD-10Collaboration
About the role
- This critical role involves conducting comprehensive MS-DRG and APR-DRG coding reviews to ensure the accuracy of claims and maximize overpayment identification.
- If you possess a CCS credential, superior knowledge of ICD-10-CM/PCS coding guidelines, and a passion for deep analytical work, you will be instrumental in supporting Cohere Health's commitment to accurate reimbursement solutions.
- This opportunity requires a self-motivated individual who thrives on precision, compliance, and continuous learning in a high-growth environment.
Responsibilities
- Utilize advanced DRG encoder tools to drive efficiency and accuracy in audits.
- Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge.
Requirements
- 6+ years experience of performing MS-DRG and ARP-DRG reviews for a Payment Integrity vendor or Payer required.
- An active certified coder credential (e.g., CIC, CPC, CCS, RHIA, or RHIT) required.
- Prepares clear, concise, and well-supported audit findings, referencing authoritative sources such as AHA Coding Clinic and ICD-10 guidelines, ensuring recommendations reflect professional expertise.
- Experience working in a start-up or high-growth company environment, demonstrating agility and adaptability.
- In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role.
Nice to have
- CCS (Certified Coding Specialist) credential highly preferred.
- Inpatient audits for case rate and per diem preferred.
Compensation
- The salary range for this position is $74,000 - $90,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus.
Benefits
- 🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program
- 📈 401K retirement plan with company match; flexible spending and health savings account
- 🏝️ Paid Time Off + company holidays
- 👶 Up to 14 weeks of paid parental leave
- The salary range for this position is $74,000 - $90,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus.
- Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement.
- Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends, and health payment policy language.
Equal opportunity
- Statement:
- Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it's personal.
- #LI-Remote
- #BI-Remote
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This listing is sourced directly from Cohere Health's careers page and normalized into a canonical job model.