Cohere Health

Cohere Health

Team Lead, DRG Auditing

United States

Sponsorship not specified$100k-$110kDetected 6 days ago
ComplianceAuditingRecruitingHIPAAICD-10CommunicationCollaboration

About the role

  • This critical role involves leading a team of auditors (such as Inpatient, Outpatient, Professional) conducting comprehensive reviews to ensure the accuracy of claims and maximize overpayment identification.
  • If you possess a CCS credential, a deep understanding of inpatient, outpatient and professional auditing, 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

  • Lead and mentor a team of auditors, managing workloads and supporting professional development.
  • Collaborate cross-functionally to align on production, quality review and meeting defined timelines.
  • 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

  • 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 using CMS NCDs/LCDs and clinical criteria guidelines.
  • 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.

Compensation

  • The salary range for this position is $100,000 to $110,000 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
  • 🏝️ Time Off + company holidays
  • 👶 Up to 14 weeks of paid parental leave
  • The salary range for this position is $100,000 to $110,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus.
  • About Cohere Health:
  • Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics.
  • Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually.
  • Its responsible AI auto-approves up to 90% of requests for millions of health plan members.

Company info

  • We are seeking a Team Lead, Auditing to join our dynamic Payment Integrity team.

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.