Payment Accuracy & Audit Specialist II

Cotiviti; United States; Remote; USD 83,097,000 - 98,140,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) plan

Paid family leave

9 paid holidays + PTO

Job summary

Cotiviti Healthcare is seeking a Payment Accuracy Specialist 2 to join the Data Mining BU in the United States. The role focuses on developing and auditing concepts to recover payments and improve compliance, with mentoring responsibilities for newer staff.

You'll work with CMS/NAIC guidelines, utilize SQL and Excel, and collaborate with Engineering to enhance reports and tools. Strong data analysis and communication skills are essential.

Qualifications

• High school diploma required.
• Bachelor's degree preferred; healthcare experience valued.
• Cotiviti experience recommended for internal growth.
• Healthcare knowledge including claim adjustments and reimbursement policies.
• Proficiency with Microsoft Office applications.
• SQL experience preferred; strong verbal and written communication.
• Comfort with large data sets and various databases.
• Ability to work independently and in a team.

Responsibilities

• Audit client data and generate recoverable claims with quality.
• Train other specialists to execute audits and concepts.
• Develop and expand audit concepts; present to clients for acceptance.
• Work under supervision to ensure production and quality goals.
• Use CMS/NAIC guidelines to establish liability order.
• Collaborate with Engineering to enhance reports and tools.
• Mentor less-tenured colleagues and onboard new hires.

Skills

SQL

Excel

Communication

Attention to detail

Data analysis

Teamwork

Healthcare knowledge

Education

High school diploma

Bachelor's degree preferred

Healthcare experience

Tools

Microsoft Office

RMS

Job description

Cotiviti Healthcare is seeking a Payment Accuracy Specialist 2 to join the Data Mining BU in the United States. The role focuses on developing and auditing concepts to recover payments and improve compliance, with mentoring responsibilities for newer staff.

You'll work with CMS/NAIC guidelines, utilize SQL and Excel, and collaborate with Engineering to enhance reports and tools. Strong data analysis and communication skills are essential.