Payment Accuracy Specialist

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

📋 Description

• Operate with moderate oversight while monitoring production efficiency and quality assessment of designated tasks.

• Develop and uphold a foundational knowledge of CMS and NAIC regulations.

• Leverage Cotiviti auditing tools to finalize audit and review documentation.

• Execute audit processes that involve identifying and articulating issues, as well as examining and evaluating evidence.

• Collaborate with the Engineering team to enhance the effectiveness of tools and reporting mechanisms.

• Make decisions based on prior expertise and understanding of client contract stipulations.

• Achieve or surpass productivity and quality benchmarks.

• Support the onboarding of new employees and the training of current staff.

⛳️ Requirements

• High School Diploma - Mandatory.

• Bachelor’s degree (Preferred).

• A minimum of 4 to 6 years of relevant experience in the healthcare sector.

• Recommended 3 to 4 years of experience with Cotiviti for individuals pursuing internal advancement.

• Experience in the healthcare industry, including knowledge of claim adjustments, provider agreements, reimbursement policies, and payment integrity (strongly preferred).

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

• Previous experience with SQL is strongly preferred.

• Exceptional verbal and written communication abilities.

• Strong enthusiasm for working with extensive data sets and diverse databases.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Disability insurance.

• Life insurance.

• 401(k) savings plan.

• Paid family leave.

• 9 paid holidays annually.

• 17 to 27 days of Paid Time Off (PTO) each year, contingent upon specific level and duration of service.