Remote Payment Integrity Analyst I

Cotiviti; Northern (KY); Hybrid; USD 36,000 - 41,000; Full time

Benefits offered by this job

Medical, Dental, Vision benefits

401(k) plan

Job summary

Cotiviti is seeking a Payment Accuracy Specialist to join our Data Mining team in the United States. You will audit client data, identify overpayments and underpayments, and produce high quality recoverable claims, while complying with HIPAA and client contracts.

This role offers growth within a rapidly expanding unit with supportive supervision and opportunities to develop advanced reporting skills. Base compensation ranges per hour, with eligibility for discretionary bonus; strong Excel and

Qualifications

• Requires a High School Diploma; Bachelor's degree preferred and/or 2–4 years healthcare experience.
• 2–3 years Cotiviti experience recommended for internal opportunities.
• Healthcare industry experience, including Medicaid claims knowledge, is strongly preferred.
• Proficient with Microsoft Office (Word, Excel, Outlook, Access).
• Excellent verbal and written communication skills.
• Strong interest in working with large data sets and various databases.

Responsibilities

• Receive direct supervision and ongoing support to ensure efficiency in production and quality review.
• Build and maintain understanding of CMS/NAIC guidelines to establish the correct liability order.
• Proficient with RMS and client systems to audit, review reports, and identify over/under-payments.
• Audit standard reports and paid claims to identify payment discrepancies and validate conclusions.
• Enter overpayments accurately and discuss findings with the team for knowledge sharing.
• Develop and run queries, update reports, and validate report accuracy against client contracts.
• Meet production and quality standards, ensuring hit rate and volume targets.
• Support onboarding of new hires and cross-training efforts.
• Identify new claim types and concepts for process improvements and tooling enhancements.

Skills

Attention to detail

Microsoft Excel

Verbal and written communication

Data analysis

Education

Bachelor's degree (Preferred)

High School Diploma - Required

Tools

Recovery Management System (RMS)

Job description

Cotiviti is seeking a Payment Accuracy Specialist to join our Data Mining team in the United States. You will audit client data, identify overpayments and underpayments, and produce high quality recoverable claims, while complying with HIPAA and client contracts.

This role offers growth within a rapidly expanding unit with supportive supervision and opportunities to develop advanced reporting skills. Base compensation ranges per hour, with eligibility for discretionary bonus; strong Excel and