[Hiring] Payment Accuracy Specialist 2 @Cotiviti

Role Description

This role involves contributing to improving healthcare payment integrity as a Payment Accuracy Specialist 2.

• Develop new and existing audit concepts
• Gain client acceptance and train all Specialist levels to execute audit projects
• Evaluate the effectiveness of audit concepts
• Audit client data and generate high-quality recoverable claims
• Conduct and train more complex audit projects with limited supervision
• Mentor, train, and develop less-tenured team members
• Display independent judgment and professional skepticism

Qualifications

• High School Diploma - Required
• Bachelor’s degree (Preferred) and/or a minimum of at least 4-6 years related experience in healthcare
• At least 3-4 years of Cotiviti experience recommended for internal opportunities
• 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
• Ability to work well in an individual and team environment
• Understands and embodies Cotiviti Core Values, Strategic Pillars, and Operations Disciplines

Requirements

• Build and maintain understanding of CMS and NAIC guidelines
• Advanced with Cotiviti audit tools and Microsoft Excel
• Perform audit procedures including identifying and defining issues
• Advanced analysis of paid claims and identification of audit findings
• Update current reports and develop custom queries
• Meet or exceed standards for productivity and quality
• Respond to inquiries and disputes on claims written
• Review transaction types, client contracts, and data
• Onboard new hires and train existing staff
• Identify new claim types and concept expansion
• Recommend new concepts and processes based on experience
• Ensure confidentiality and security of all data, adhering to HIPAA laws

Benefits

• Base compensation ranges from $29.00 to $33.00 per hour
• Eligible for discretionary bonus consideration
• Overtime pay for hours worked in excess of 40 hours per week
• Competitive benefits package including medical, dental, vision, disability, and life insurance
• 401(k) savings plans
• Paid family leave
• 9 paid holidays per year
• 17-27 days of Paid Time Off (PTO) per year