2025-17027

Overview

The Clinical Abstractor will function as support of the HEDIS® Team during the traditional HEDIS® season and/or during off-season projects. The Clinical Abstractor will perform at minimum abstraction of assigned measures and training as part of their responsibilities. HEDIS® is a registered trademark of NCQA.

Responsibilities

Works in conjunction with Clinical Abstraction Team Leads and/or Management to complete training and subsequent abstraction by measure specific team assignment.
Abstraction includes medical record review of specific measure criteria and entering findings into abstraction tool. Medical records could either be part of an electronic medical record (EMR)or digital records (i.e. PDF).
Will escalate matters to Clinical Abstraction Team Leads or Manager as appropriate.
Collaborates with other Clinical Abstractors and will always demonstrate Cotiviti core values.
Will adhere to compliance of the remote policy, HIPAA regulations, professional conduct and ethical practice.
Complete all responsibilities as outlined in the annual performance review and/or goal setting.
Complete all special projects and other duties as assigned.
Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications

Current licensed Registered Nurse/Licensed Practical Nurse, RHIT certification or certified Medical Coder.
Minimum of 2 years of experience with NCQA HEDIS® Hybrid measure abstraction.
Experience working with HEDIS® data entry software and reporting tools.
Experience working remotely on team projects.
Must be comfortable communicating via various modes (email, IM, phone) in a timely manner.
Must be comfortable using/learning Microsoft Office products (SharePoint, Outlook. Teams, Word, Excel, etc.).

Job Demands

This is a seasonal role and the HEDIS season will tentatively be starting on Monday, January 12, 2026 (running through the first week of May...this is an estimate). You must be able to work on January 12th starting at 10 AM ET - 1 PM ET. Additionally, you will need to work 20 hours throughout the first week to accomplish required training (this is self paced and hours/days can vary).
You must be able to work a minimum of 20 hours per week and can work up to 40 hours per week (days/working times are flexible).
This position is a remote working position but you must be working in the United States. Access to high-speed internet and secure working environment is required. All equipment will be provided.

Mental Requirements

Must be comfortable communicating in various modes (email, IM, phone) in a timely manner.
Comfortable using/learning Microsoft Office products.
Analytical and problem-solving skills.
Ability to use data to identify patterns and trends.
Adaptable with problem solving skills.
Must possess strong communication skills to convey information across multiple team members.
Able to work in a fast-paced environment.

Working Conditions and Physical Requirements

Remaining in a stationary position, often standing or sitting for prolonged periods.
Repeating motions that may include the wrists, hands and/or fingers.
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.

Base compensation ranges from $25.00 to $37.00 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Non-Exempt 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.

Date of posting: 11/7/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 12/7/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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A little more than three years ago, I found Cotiviti by chance, and I learned …

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Laury

Coding Trainer

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Cotiviti is an equal employment opportunity employer. Cotiviti recruits, hires and promotes individuals based on their qualifications for a specific job. Selection of employees is made without regard to race, color, creed, sex, age, religion, pregnancy or pregnancy-related conditions, national origin, sexual orientation, gender identity, marital status, genetic carrier status, military service, veteran status, uniformed service member status, disability, or any other category of class protected by federal, state or local laws. All employment decisions and personnel actions, such as hiring, promotion, compensation, benefits, and termination, are and will continue to be administered in accordance with, and to further the principle of, equal employment opportunity.

Pay Transparency Nondiscrimination Provision

Cotiviti will not discharge or in any manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-I.35(c)

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