Payment Accuracy Specialist

🔥 9 minutes ago

🇺🇸 United States – Remote

💵 $29 - $34 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

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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

• Work under moderate supervision and monitor efficiency in production and quality review of assigned work • Build and maintain a basic understanding of CMS and NAIC guidelines • Utilize Cotiviti audit tools to complete auditing and review reports • Perform audit procedures that include identifying and defining issues, reviewing, and analyzing evidence • Work with Engineering to increase efficiency of tools and reporting • Make determinations based on prior knowledge and experience of client contract terms • Meet or exceed standards for productivity and quality • Assist in onboarding new hires and training existing staff

🎯 Requirements

• High School Diploma - Required • Bachelor’s degree (Preferred) • Minimum of at least (4 - 6) years related experience in healthcare • At least 3 - 4 years of Cotiviti experience recommended for individuals seeking their next opportunity internally • Healthcare industry experience, including knowledge of claim adjustments, provider contracts, reimbursement policies and payment integrity (strongly preferred) • Computer proficiency including Microsoft Office (Word, Excel, Outlook, Access) • Previous SQL experience strongly preferred • Excellent verbal and written communication skills • Strong interest in working with large data sets and various databases.

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance • 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