Payment Accuracy Specialist 1 – Coordination of Benefits

🕒 5 days ago

🇺🇸 United States – Remote

💵 $23 - $26 / 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

• Review and analyze multi-client impact, complex member selection, and query or filter construction to identify recoverable Coordination of Benefits claims • Establish the correct order of liability for client members • Input accurate claim recovery information into Cotiviti proprietary software tools • Assist with inquiries throughout the claim recovery process • Complete moderate to more complex audit projects • Run and establish queries and filters for data reports • Resolve data-related challenges • Apply CMS and NAIC guidelines to determine liability accurately • Use Recovery Management System (RMS), COB Tracker, and client systems for member investigations • Create accurate, detailed notes in Cotiviti and/or client audit tools • Review concept and claim identifications while meeting production and quality standards • Prepare and evaluate responses to internal and external client disputes • Identify opportunities to improve reporting efficiency and streamline research processes • Follow Cotiviti policies, procedures, regulatory requirements, and HIPAA data confidentiality and security requirements • Analyze information from multiple sources, consider broader context, and develop improved work processes • Work independently and collaboratively under limited supervision

🎯 Requirements

• High School Diploma required • Bachelor’s degree preferred • Minimum of 2 years of related healthcare experience • At least 1-2 years of Cotiviti experience recommended for internal candidates seeking their next opportunity • Healthcare industry experience, including required knowledge of Coordination of Benefits • Computer proficiency, including Microsoft Office (Word, Excel, 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 and practical 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 investigate issues, inconsistencies, and irregularities • Ability to work effectively as part of an audit team • Excellent verbal and written communication skills • Ability to work independently and collaboratively • Must provide a dedicated, secure work area • Must provide high-speed internet access / connectivity and office setup and maintenance • Must comply with HIPAA laws and requirements and applicable industry standards

🏖️ 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 • Remote work arrangement • Dedicated secure work area and high-speed internet / connectivity and office setup and maintenance