Payment Accuracy Specialist 1 – Coordination of Benefits

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $22 - $26 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👩‍👩‍👧‍👦 Human Resources (HR)

🚫👨‍🎓 No degree required

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

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 the multi-client impact, complex member selection, and query or filter construction of data • Identify instances of recoverable Coordination of Benefit claims for the benefit of Cotiviti and our clients • Input accurate claim recovery information in Cotiviti software tools and assist with related inquiries throughout the claim recovery process • Work under limited supervision with monitored efficiency in production and quality review of assigned work • Demonstrate proactive problem-solving skills and resolve data-related challenges efficiently • Utilize Cotiviti audit tools (RMS, COB Tracker) to complete member investigations • Prepare and evaluate responses to client disputes both internally and externally within the Business Unit as needed • Identify opportunities for continuous improvement for efficiencies within reporting and streamlining research processes.

🎯 Requirements

• High School Diploma - Required • Bachelor’s degree (Preferred) and/or a minimum of at least two (2) years related experience in healthcare • At least 1-2 years of Cotiviti experience is recommended for individuals seeking next opportunity internally • Healthcare industry experience, including knowledge of Coordination of Benefits (Required) • Computer proficiency including Microsoft Office (Word, Excel, Outlook) • Excellent verbal and written communication skills • Strong interest in working with large data sets and various databases. • Ability to analyze large volumes of data, identify trends, discrepancies, and anomalies. • Must have exceptional attention to detail to ensure accuracy in financial records and audit findings. • Strong critical thinking skills, with the ability to assess complex situations, identify key issues, and propose practical solutions.

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance • 401(k) savings plans • Paid family leave • Paid time off (PTO) • 9 paid holidays per year • 17-27 days of PTO depending on service