[Hiring] Team Lead, Payment Accuracy @Cotiviti

Role Description

The Team Lead is a member of the Coordination of Benefits team, involving situations in which an individual is covered by two or more health plans. Individuals in the Senior Specialist Team Lead role are passionate about leading a team to accomplish the identified goals for the success of the team, Cotiviti, and client partnerships. This role is responsible for leading a team of individuals to meet established goals and deliver on both internal and external client requirements.

• Empowered to lead your assigned team with strategic autonomy, making critical operational decisions and working closely with Senior Leadership to drive team performance and innovation.
• Recruit, develop, coach, lead and retain diverse talent from varied backgrounds, focusing on building an inclusive team and culture that employs equitable practices to support and drive high levels of internal and external customer satisfaction.
• Performs time management reviews for payroll processing utilizing a time management system, ensuring employees are working an approved schedule by leadership, applying necessary time off codes, and adhering to company policies for timely approval.
• Performs performance management of employees to ensure employees are meeting and achieving work expectations and deliverables.
• Performs goal planning and distribution, 30/60/90-day onboarding reviews for new hires and/or individuals newly promoted in a role, performance review check-ins and annual performance reviews.
• Participates in assigned leadership training as assigned as well as enhances individual leadership skills by participating in LinkedIn Learning self–directed sessions.
• Creates and maintains standard operating procedures as well as training manual and materials.
• Provides mentorship and guidance to team members through coaching, training and/or 1:1s.
• Completes bi–weekly or monthly 1:1 meetings/team meetings with team members to review individual and team performance.
• Participates in functional leadership presentations for townhalls, clients and/or other projects as assigned, internally and externally.
• A subject matter expert on all levels of work scope and clients reporting into Team Lead.
• Forecasts projected productivity to review financial targets with Senior Leadership and identify solutions should projects demonstrate a deviance to the target.
• Creates and assigns work as required to team members for each level within their scope.
• Has subject matter expertise in understanding of Centers for Medicare and Medicaid Services (CMS) and National Association of Insurance Commissioners (NAIC) guidelines to establish correct order of liability.
• Has full understanding of client parameters and can communicate these effectively to team members and others throughout the organization.
• Demonstrates subject matter expert level of understanding of query and filter construction to identify opportunity.
• Performs additional quality control review of team members work, as well as assists with senior management in quality review summary.
• Has advanced level of knowledge of Cotiviti audit tools (Recovery Management System (RMS), COB Tracker, specific client systems) and can articulate to team members when to utilize various systems.
• Monitors production of team members against established goals; assists with formulating plan if goals are not being consistently met.
• Meets or exceeds standards of production and quality as identified by compliance and regulatory guidelines and set forth by the Manager when reviewing concept and claim identifications for the client.
• Prepares and evaluates responses to client disputes both internally and externally within the Business Unit.
• Displays ability to use multiple computer software, systems, and technology.
• Identifies opportunities for continuous improvement for efficiencies within reporting and streamline research processes.
• Has an in-depth understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements.
• Has an advanced understanding of the healthcare industry, as well as proven track record of delivering results.
• Assures confidentiality and security of all data, adhering to all HIPAA (Health Insurance Portability and Accountability) laws and requirements.
• Has ability to take responsibility for outcome, whether positive or negative and apply learning as applicable.
• Integrates information from various sources and considers broader context.
• Drive transformative innovation by developing creative solutions that optimize operational workflows and exceed traditional performance benchmarks.
• Actively seeks information to understand rationale and provide exceptional results beyond basic standards.

Qualifications

• High School Diploma - Required.
• Bachelor’s degree (Preferred) and/or a minimum of at least five (5) years related experience in healthcare.
• At least 3-4 years Cotiviti experience is recommended for individuals seeking their next opportunity internally.
• Prior exposure mentoring, leading a team, and responsibility for team outcomes in addition to individual outcomes (Preferred).
• Healthcare industry experience, including knowledge of Coordination of Benefits. (Required).
• Computer proficiency including Microsoft office (Word, Excel, Outlook).

Requirements

• Mental Requirements:
• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.
• Physical Requirements and Working Conditions:
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Benefits

• Base compensation ranges from $80,000 to $95,000 per year.
• This role is eligible for discretionary bonus consideration.
• Cotiviti offers a competitive benefits package including:
• 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.

Company Description

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job change.