Audit Support Assistant I

Cotiviti; Hyderabad; On-site; INR 279,000 - 446,000; Full time

Job summary

Cotiviti in Hyderabad seeks graduates for a claims audit and data validation role. You will call US healthcare payers/providers to collect and verify claim information, review client systems, and audit claims and EOBs to identify discrepancies.

Strong verbal and written communication, analytical thinking, and attention to detail are essential. Night US shifts and adherence to SOPs, data security, and quality targets are part of the role, with training provided.

Qualifications

• Graduate in any discipline.
• Maximum 4 years of experience in US Healthcare, BPO, Claims, or related processes.
• US Healthcare experience preferred, esp. Payer/Provider Calling or Claims.
• Freshers with excellent communication skills may be considered.
• Strong verbal and written communication skills.
• Good analytical and problem-solving skills.
• Ability to interpret data and make timely decisions.
• Ability to work independently and handle multiple projects simultaneously.
• Willingness to work in night/US shifts.
• Good attention to detail and ability to follow defined processes and SOPs.

Responsibilities

• Call multiple US healthcare payers/providers to collect and validate required claim information.
• Access client applications and review relevant claim information.
• Audit claims and EOBs to identify incorrect or overpaid claims.
• Perform audits based on client policies, procedures, and SOPs.
• Analyze claims and supporting documents to validate overpayments.
• Collect accurate information and documentation required for claim resolution.
• Maintain clear and accurate documentation of audit findings and outcomes.
• Manage assigned inventory and meet defined productivity, quality, and SLA targets.
• Use available tools and applications to resolve assigned cases.
• Follow process SOPs and stay updated with process changes.
• Implement feedback from managers and quality teams to improve performance.
• Maintain compliance with internal controls and data-security requirements.

Skills

Verbal communication

Written communication

Analytical skills

Problem solving

Attention to detail

Data interpretation

Independent work

Education

Graduation in any discipline

Job description

Role & Responsibilities

• Call multiple US healthcare payers/providers to collect and validate required claim information.
• Access client applications and review relevant claim information.
• Audit claims and EOBs to identify incorrect or overpaid claims.
• Perform audits based on client policies, procedures, and SOPs.
• Analyze claims and supporting documents to validate overpayments.
• Collect accurate information and documentation required for claim resolution.
• Maintain clear and accurate documentation of audit findings and outcomes.
• Manage assigned inventory and meet defined productivity, quality, and SLA targets.
• Use available tools and applications to resolve assigned cases.
• Follow process SOPs and stay updated with process changes.
• Implement feedback from managers and quality teams to improve performance.
• Maintain compliance with internal controls and data-security requirements.

Preferred Candidate Profile

• Graduate in any discipline.
• Maximum 4 years of experience in US Healthcare, BPO, Claims, or related processes.
• US Healthcare experience is preferred, especially Payer/Provider Calling or Claims.
• Freshers with excellent communication skills may also be considered.
• Strong verbal and written communication skills.
• Good analytical and problem-solving skills.
• Ability to interpret data and make timely decisions.
• Ability to work independently and handle multiple projects simultaneously.
• Willingness to work in night/US shifts.
• Good attention to detail and ability to follow defined processes and SOPs.