Cohere Health is a healthcare technology company, focused on improving the efficiency and effectiveness of healthcare delivery. Backed by Flare Capital Partners.
About the role
We are seeking a Team Lead, Auditing to join our dynamic Payment Integrity team. 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.
What they're looking for
- 8 + years experience of performing MS-DRG and ARP-DRG reviews for a Payment Integrity vendor or Payer
- 2-3 years of supervisory/management experience, including supervising and training in a remote work environment
- CCS (Certified Coding Specialist) credential highly preferred
- RHIA, or RHIT credential, Associate's Degree in Health Information Management, Nursing, or related field preferred
- Preference for candidates holding both a coding credential and an HIM credential (RHIA/RHIT)
- 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
More about this role
We are seeking a Team Lead, Auditing to join our dynamic Payment Integrity team. 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 RHIA, RHIT or 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.
- 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.
- Conduct comprehensive coding reviews to ensure accuracy and reimbursement.
- Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
- Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and...
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