Payment Accuracy Specialist

🕒 August 25

🇺🇸 United States – Remote

💵 $21 - $24 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 34%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 • Perform audits involving Data Mining, Claim Adjudication, Contract Compliance, Provider Billing and Duplicate Payment Reviews, Policy and Reimbursement Analysis, and Quality Assurance • Meet productivity, attendance, production, hit-rate, claim-volume, identification-per-hour, quality, and documentation standards • Prepare and evaluate responses to internal and external client disputes • Review client transactions using provider contracts and vendor agreements • Recommend applications of medical policies, state and federal statutes, and reimbursement methodologies • Maintain confidentiality and security of data in accordance with HIPAA and industry standards

🎯 Requirements

• High School Diploma — Required • Bachelor’s degree preferred • Minimum of 1–2 years of related experience in healthcare • At least 1–2 years of Cotiviti experience 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 • Self-motivation to deliver success • 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 • Compliance with HIPAA laws and requirements and external regulatory requirements • Ability to remain in a stationary position, often standing or sitting for prolonged periods • Ability to repeat motions that may include the wrists, hands, and/or fingers

🏖️ Benefits

• Discretionary bonus consideration • Medical insurance coverage • Dental insurance coverage • Vision insurance coverage • Disability insurance coverage • 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 specific level and length of service • Overtime pay for nonexempt employees for hours worked in excess of 40 hours per week, or as required by applicable state law • Dedicated, secure work area and high-speed internet access/connectivity and office setup and maintenance provided by the candidate