Payment Accuracy Specialist 1 – Coordination of Benefits

This is a fully remote position, open to applicants in United States.

📋 Description

• Analyze and review the impact on multiple clients, complex member selection, and the construction of data queries or filters.

• Identify recoverable Coordination of Benefit claims that benefit both Cotiviti and our clients.

• Accurately input claim recovery data into Cotiviti software tools and assist with inquiries throughout the recovery process.

• Operate under limited supervision while maintaining monitored efficiency in the production and quality review of assigned tasks.

• Exhibit proactive problem-solving abilities to efficiently address data-related challenges.

• Utilize Cotiviti audit tools (RMS, COB Tracker) to conduct thorough member investigations.

• Prepare and assess responses to client disputes both internally and externally within the Business Unit as needed.

• Identify and propose opportunities for continuous improvement in reporting and streamlining research processes.

⛳️ Requirements

• High School Diploma - Required

• Bachelor’s degree (Preferred) and/or at least two (2) years of relevant experience in healthcare.

• Recommended 1-2 years of Cotiviti experience for individuals pursuing internal advancement.

• Experience in the healthcare industry, particularly with Coordination of Benefits knowledge (Required).

• Proficiency in computer applications, including Microsoft Office (Word, Excel, Outlook).

• Strong verbal and written communication skills.

• A keen interest in working with extensive data sets and various databases.

• Ability to analyze large amounts of data to identify trends, discrepancies, and anomalies.

• Exceptional attention to detail is required to ensure accuracy in financial records and audit findings.

• Strong critical thinking skills, capable of assessing complex situations, identifying key issues, and proposing practical solutions.

🏝️ Benefits

• Medical insurance

• Dental insurance

• Vision insurance

• Disability insurance

• Life insurance

• 401(k) savings plans

• Paid family leave

• Paid time off (PTO)

• 9 paid holidays per year

• 17-27 days of PTO depending on service