Payment Accuracy COB Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $20 - $23 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 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

• 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 in Coordination of Benefits cases • Input accurate claim recovery information into proprietary Cotiviti software tools • Assist with inquiries throughout the claim recovery process • Apply CMS and NAIC guidelines to determine liability order • Conduct member investigations using Recovery Management System (RMS), COB Tracker, and client-specific systems • Create accurate notes in Cotiviti and/or client audit tools • Meet or exceed production and quality standards under direct supervision • Prepare and evaluate responses to client disputes • Classify errors and overpayments for healthcare clients and solve related problems • Identify continuous-improvement opportunities in reporting and research processes • Follow Cotiviti policies, procedures, HIPAA requirements, and external regulations • Complete performance-plan responsibilities, special projects, and assigned duties

🎯 Requirements

• High School Diploma required • Bachelor’s degree preferred • Minimum of 1 year of related healthcare experience • 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 work independently and in team environments • Ability to analyze large volumes of data and identify trends, discrepancies, and anomalies • Exceptional attention to detail • Strong critical-thinking and problem-solving skills • 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 provide a dedicated, secure work area • Must 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 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 • High-speed internet access / connectivity and office setup and maintenance required for the role