Payment Accuracy Specialist

🕒 September 8

🇺🇸 United States – Remote

💵 $20 - $23 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Review and analyze claims, member, and group data to identify recoverable claims • Establish the correct order of liability for clients’ members • Input accurate claim recovery information into Cotiviti proprietary software tools • Assist with inquiries throughout the claim recovery process • Work under direct supervision and meet production and quality standards • Apply CMS and NAIC guidelines to determine liability order • Use Recovery Management System (RMS), COB Tracker, and client-specific systems to conduct member investigations • Create accurate notes in Cotiviti and/or client audit tools • Review concept and claim identifications for clients • Prepare and evaluate responses to internal and external client disputes • Classify errors and overpayments for healthcare clients • Identify continuous-improvement opportunities in reporting and research processes • Follow Cotiviti policies, procedures, HIPAA requirements, and external regulations • Complete annual Performance Plan responsibilities and assigned special projects

🎯 Requirements

• High School Diploma - Required • Bachelor’s degree (Preferred) and/or a minimum of one (1) year of related experience in healthcare • At least 1-year Cotiviti experience is recommended for individuals seeking their next opportunity internally • Healthcare industry experience, including knowledge of Coordination of Benefits (Preferred) • Computer proficiency including Microsoft Office (Word, Excel, Outlook) • Excellent verbal and written communication skills • Enthusiasm for working with large datasets and diverse databases • Ability to analyze large volumes of data and identify trends, discrepancies, and anomalies • Exceptional attention to detail • Strong critical thinking skills and ability to assess complex situations and propose practical solutions • Ability to make informed decisions based on data, regulations, and auditing standards • Strong understanding of auditing standards, regulations, and industry best practices • Ability to recognize issues requiring further investigation • 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 • Must be able to perform duties with or without reasonable accommodation

🏖️ Benefits

• Discretionary bonus consideration • Medical insurance coverage • Dental insurance coverage • Vision insurance coverage • Disability insurance coverage • Life insurance coverage • 401(k) savings plan • Paid family leave • 9 paid holidays per year • 17–27 days of Paid Time Off (PTO) per year, depending on level and length of service • Overtime pay for nonexempt employees for hours worked over 40 hours per week, or as required by applicable state law • Remote work arrangement • Dedicated, secure work area and high-speed internet/office setup supported as a working condition