Payment Accuracy COB Specialist 2

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $26 - $29 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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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

• Collaborate with all levels of the business on assigned projects and deliverables • Serve as a subject matter expert and share knowledge with Specialists and Specialist 1 employees • Introduce new ideas, research, and creative thinking • Distribute inventory and assign filters, queries, and/or call assignments to team members • Perform advanced audits for multiple clients • Conduct quality checks, exports, appeals, and competitive intelligence activities • Apply CMS and NAIC guidelines to establish the correct order of liability • Independently select members in Cotiviti tools using client parameters • Construct queries and filters to identify opportunities • Use RMS, COB Tracker, and client systems to complete member investigations • Create accurate, detailed investigation notes in Cotiviti and client audit tools • Meet or exceed production and quality standards for concept and claim identifications • Prepare and evaluate responses to client disputes • Identify errors and overpayments for healthcare clients • Identify continuous-improvement opportunities in reporting and research processes • Perform duties in accordance with Cotiviti policies, procedures, HIPAA requirements, and external regulations • Analyze information from multiple sources and consider broader context • Develop innovative pathways to improve the standard operating rhythm and work processes

🎯 Requirements

• High School Diploma required • Bachelor’s degree preferred • 2-4 years of related healthcare experience • Healthcare industry experience, including knowledge of Coordination of Benefits, required • 1-2 years of Cotiviti experience recommended for internal candidates • Computer proficiency, including Microsoft Office, Word, Excel, and Outlook • Strong interest in working with large data sets and various databases • Ability to analyze large volumes of data and identify trends, discrepancies, and anomalies • Exceptional attention to detail for financial records and audit findings • 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 investigate financial records and uncover issues, inconsistencies, and irregularities • Ability to work effectively independently and as part of an audit team • Ability to provide a dedicated, secure work area • Ability to provide high-speed internet access/connectivity and office setup and maintenance • Ability to comply with HIPAA laws, industry standards, Cotiviti policies, and regulatory requirements

🏖️ Benefits

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