Audit Support Assistant I

Cotiviti; Hyderabad; On-site; INR 300,000 - 420,000; Full time

Job summary

Cotiviti Hyderabad is seeking a detail-oriented candidate to handle outbound calls to US healthcare payers and providers, collecting and validating claim information, reviewing client applications, and auditing claims and EOBs to identify overpayments.

The ideal candidate has a graduate degree, up to four years’ experience in US healthcare/BPO, strong communication, data interpretation, and the ability to work night US shifts while maintaining accuracy and adherence to SOPs.

Qualifications

• 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.

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

Data interpretation

Decision making

Independent worker

Multitasking

Education

Any degree

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.