Payment Accuracy COB Specialist

🕒 il y a 8 jours

🇺🇸 États-Unis – Télétravail

💵 $20 - $23 / heure

⏰ Temps Plein

🟢 Junior

🚫👨‍🎓 Aucun diplôme requis

🦅 Parrain de Visa H1B

Cette entreprise a parrainé des visas H1B par le passé.

👻 Score fantôme 0%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Cotiviti

Site WebLinkedInTous les Emplois

5001 - 10000 employés

🏥 Santé

💼 Conseil

📦 Logistique

Healthcare • Consulting • Logistics

Cotiviti est une entreprise de technologie et d'analytique dans le secteur de la santé, spécialisée dans l'amélioration de l'exactitude des paiements et des performances grâce à des solutions avancées d'analytique de données. Elle collabore avec des régimes de santé, des agences gouvernementales et des prestataires de soins de santé pour fournir des insights qui améliorent la qualité et l'efficacité de la prestation de soins. Grâce à des solutions telles que l'ajustement des risques, la gestion des politiques de paiement et l'engagement des membres, Cotiviti vise à optimiser les résultats financiers et cliniques pour l'écosystème de la santé.

Description

• Review and analyze claims, member, and group data to identify recoverable claims for Cotiviti and its clients • Establish the correct order of liability for clients’ members • Input accurate claim recovery information into Cotiviti software tools • Assist with related inquiries throughout the claim recovery process • Work under direct supervision with monitoring for production efficiency and quality • Develop and uphold knowledge of CMS and NAIC guidelines to determine liability order • Use the Recovery Management System (RMS), COB Tracker, and client-specific systems to conduct member investigations • Create accurate, detailed notes in Cotiviti and/or client audit tools • Meet or exceed production and quality standards for claim identification and review • Prepare and evaluate responses to internal and external client disputes • Classify errors and overpayments for healthcare clients and solve related problems • Identify continuous-improvement opportunities in reporting and research processes • Perform duties in accordance with Cotiviti policies, procedures, HIPAA, and external regulatory requirements • Complete annual Performance Plan responsibilities, special projects, and other assigned duties

🎯 Exigences

• 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 to ensure accuracy in financial records and audit findings • Strong critical thinking skills and ability to assess complex situations, identify key issues, 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 when something is wrong or needs further investigation • 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

🏖️ Avantages

• Discretionary bonus consideration • Overtime pay for nonexempt employees for hours worked over 40 per week, or as required by state law • Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance • 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