Payment Accuracy Specialist

🔥 15 hours ago

🇺🇸 United States – Remote

💵 $21 - $24 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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👻 Ghost score 0%

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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

• Audit client data and generate high-quality recoverable claims for Cotiviti and its clients. • Identify and input recovery claims, voids, and other over- or underpayment types under direct supervision. • Document relevant facts, information, and conclusions to support work and validate claims. • Communicate audit recommendations to the supervisory auditor for evaluation, verification, and continuous learning. • Build and maintain a basic understanding of CMS and NAIC guidelines to establish the correct order of liability. • Use Cotiviti audit tools, including Recovery Management System (RMS), client systems, Microsoft Excel, and client applications. • Audit standard reports and paid claims to identify overpayments and underpayments across various audit scopes. • Meet productivity, attendance, quality, hit-rate, claims-written, and identification-per-hour standards. • Prepare and evaluate responses to internal and external client disputes. • Review client transactions and build proficiency in provider contracts and vendor agreements. • Recommend applications of medical policies, state and federal statutes, and reimbursement methodologies. • Follow Cotiviti policies, procedures, and external regulatory requirements. • Ensure confidentiality and security of data in accordance with HIPAA and industry standards.

🎯 Requirements

• High School Diploma - Required. • Bachelor’s degree (Preferred) and/or a minimum of 1–2 years related experience in healthcare. • At least 1–2 years 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. • Strong interest in working with large data sets and various databases. • Ability to work well in an individual and team environment, demonstrating self-motivation. • Understanding of Cotiviti Core Values, Strategic Pillars, and Operations Disciplines. • Ability to provide a dedicated, secure work area. • Ability to provide high-speed internet access/connectivity and office setup and maintenance. • Ability to meet HIPAA confidentiality and security requirements.

🏖️ Benefits

• Discretionary bonus consideration • Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance coverage • 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 • Dedicated, secure work area • High-speed internet access/connectivity and office setup and maintenance