Senior Payment Accuracy Specialist

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $37 - $40 / hour

⏰ Full Time

🟠 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

• Generates and Develops New Audit Concepts • Utilizes healthcare and auditing experience to perform audit procedures that include identifying and defining issues, developing criteria, reviewing and analyzing evidence with the intent to audit standard medium and complex reports • Leader in concept development across multiple audit verticals • Develops New Tools and Processes • Collaborates with Business Optimization and audit team in developing new reports • Directs ownership for Quality Control • Prepares Responses to Client Disputes • Reviews provider Contracts • Validates New Claim Types • Auditor Development • QA Claim Association/Concepts

🎯 Requirements

• Bachelor's degree preferred • Three (3) years of Cotiviti direct audit experience OR four (4) years related experience (healthcare billing, healthcare/medical claims, reimbursement, analytics) required • Experience using SQL required • Computer proficiency in Microsoft Excel, Access and system databases are required • Ability to mentor staff and enhance performance as it relates to the quality and productivity of their auditors • Prior Healthcare Billing and/or claims experience desired • Requires working knowledge of and applicable industry based standards • Excellent verbal and written communication skills • Ability to work well in an individual and team environment

🏖️ Benefits

• medical, dental, vision, disability, and 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 with Cotiviti