QA I – Coding Operations

Cotiviti

. Monitor and report the accuracy of coding performed by Cotiviti and third-party partner coders .

Posted 10/30/2026part-timeRemote • United StatesJunior💰 $26 - $33 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in HCC mapped diagnosis coding and medical record auditing, ensuring adherence to coding guidelines and regulatory compliance. Strong analytical skills and the ability to provide coaching and feedback to coders while maintaining high performance in quality and production goals.

Highest-signal resume keywords

HCC Coding ExperienceCoding Certification (CPC, CRC, CCS)Medical Record AuditingRegulatory Compliance (CMS, HIPAA)Analytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

HCC Mapped Diagnosis CodingMedical Record AuditingCoding Guidelines AdherenceQuality Assurance ReviewsTrend Identification in Coding ErrorsMedical Terminology KnowledgeAnatomy and Physiology KnowledgeProduction and Quality Goal AchievementInternal AuditsAction Plan Development

Soft Skills

Coaching SkillsInterpersonal SkillsWritten Communication SkillsVerbal Communication SkillsOrganizational Skills

Tools & Technologies

Cotiviti Training ToolsCoding LibraryQuality ReportsQuestions Queue

Certifications & Qualifications

AAPC CertificationAHIMA CertificationCPCCRCCCS

Industry Keywords

Coding ComplianceRisk Adjustment CodingClient-Specific GuidelinesQuality StandardsMedical Record Documentation

About the role

Key responsibilities & impact

Monitor and report the accuracy of coding performed by Cotiviti and third-party partner coders
Provide direct coaching and feedback to coders
Conduct QA and audit reviews and support remediation for risk adjustment coding services
Liaise between Coder I, Coder II, and the Team Lead to ensure coding is complete and accurate
Review a defined percentage of Coder I and Coder II work against quality standards
Review charts and encounters for proper HCC-mapped diagnosis coding across physician, facility, and non-facility chart types
Review prospective, concurrent, and retrospective coding
Ensure coding follows client-specific and industry-standard guidelines and accurately reflects medical-record documentation
Communicate findings, errors, suggestions, quality issues, and trends to coders, QA II, team leads, and managers
Complete internal audits and review quality reports on daily, weekly, monthly, quarterly, and yearly schedules
Recommend additional training based on quality audit results, including for coders below the 95% accuracy rate
Develop action plans with Team Leads and Managers and report progress
Respond to coder questions through the Questions Queue
Use Cotiviti training tools and coding library
Complete annual performance-plan responsibilities, special projects, and other assigned duties

Requirements

What you’ll need

High School diploma required; Bachelor's degree preferred
Clinical background preferred
Coding certification required through AAPC or AHIMA (CPC, CRC, CCS, etc.)
Expertise in medical record auditing, particularly in HCC mapped diagnosis coding
Minimum of one to three years HCC coding experience
Demonstrated high performance in meeting or exceeding production and quality goals
Adherence to official coding guidelines, coding clinic determinations, client specific coding guidelines, CMS and other regulatory compliance guidelines and mandates
Ability to read and understand medical record documentation
Ability to identify trends in coding and documentation errors, including over- and under-coding
Excellent written and verbal skills, including coaching and interpersonal skills
Strong knowledge of medical terminology and anatomy and physiology
Skilled in organization and customer service
Computer and technology literate
Analytical and problem solving skills
Ability to manage and meet deadlines
Flexibility to provide assistance in emergent situations and/or projects
Must participate in required training
Must abide by HIPAA and associated patient confidentiality requirements
Must be able to perform duties with or without reasonable accommodation
Must be able to provide a dedicated, secure work area
Must be able to provide high-speed internet access/connectivity and office setup and maintenance

Benefits

Comp & perks

Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law
Virtual interviews
Reasonable accommodation where applicable
Dedicated, secure work area and high-speed internet access/connectivity and office setup and maintenance required for remote work