Remote Payment Accuracy & Data Mining Specialist

Cotiviti; United States; Remote; USD 44,000 - 51,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k)

Paid time off

Paid holidays

Job summary

Cotiviti is seeking a Payment Accuracy Data Mining Specialist to audit client data and generate high quality recoverable claims. You will work under direct supervision, building knowledge of CMS/NAIC guidelines and using RMS to review claims and reports.

Strong Excel skills and healthcare data understanding are essential for success. Responsibilities include auditing disputes, maintaining quality standards, and communicating findings to supervisory auditors for evaluation.

Qualifications

• High School Diploma is required.
• Bachelor’s degree preferred and/or 1–2 years healthcare experience.
• 1–2 years Cotiviti experience recommended for internal opportunities.
• Healthcare industry experience, including knowledge of Coordination of Benefits.
• Proficient with Microsoft Office (Word, Excel, Outlook).

Responsibilities

• Under direct supervision, audit client data and identify recoverable claims.
• Build familiarity with CMS and NAIC guidelines to determine liability.
• Use RMS and client systems to review reports and prepare documentation.
• Audit standard reports and paid claims for overpayments and underpayments.
• Meet productivity and quality standards and maintain attendance as required.
• Prepare responses to client disputes and review transactions with provider contracts.

Skills

Data mining

Audit experience

Microsoft Excel

Healthcare data

Education

High School Diploma

Bachelor’s degree

Tools

RMS

Client systems

Office Suite

Job description

Cotiviti is seeking a Payment Accuracy Data Mining Specialist to audit client data and generate high quality recoverable claims. You will work under direct supervision, building knowledge of CMS/NAIC guidelines and using RMS to review claims and reports.

Strong Excel skills and healthcare data understanding are essential for success. Responsibilities include auditing disputes, maintaining quality standards, and communicating findings to supervisory auditors for evaluation.