Data Mining Auditor: Payment Accuracy & Claims Recovery

Cotiviti; United States; On-site; USD 29,000 - 33,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

401(k) savings plans

Paid family leave

9 paid holidays per year

PTO

Job summary

Cotiviti is seeking a Payment Accuracy Data Mining (DM) Specialist to audit client data and generate high‑quality recoverable claims under supervision. You will input recovery claims, voids, or other adjustments, document findings, and communicate recommendations to supervisory auditors.

The role requires understanding CMS/NAIC guidelines, HIPAA compliance, and collaboration to meet productivity and quality targets.

Qualifications

• Experience auditing healthcare data and generating recoverable claims.
• Ability to document facts and conclusions to support audit work.

Responsibilities

• Audit standard reports and paid claims to identify overpayments and underpayments.
• Build understanding of CMS/NAIC guidelines to establish liability order.
• Use RMS and client systems to complete auditing and review reports.
• Meet productivity and quality standards while maintaining attendance.

Skills

Data Mining

Audit Skills

Excel

Attention to detail

HIPAA knowledge

Education

Bachelor's degree

Tools

RMS

Excel

Client applications

Job description

Cotiviti is seeking a Payment Accuracy Data Mining (DM) Specialist to audit client data and generate high‑quality recoverable claims under supervision. You will input recovery claims, voids, or other adjustments, document findings, and communicate recommendations to supervisory auditors.

The role requires understanding CMS/NAIC guidelines, HIPAA compliance, and collaboration to meet productivity and quality targets.