Cotiviti Healthcare provides payment accuracy services focused on healthcare payment integrity. The Payment Accuracy Specialist 2 is part of the Data Mining Business Unit, responsible for developing and executing audit concepts related to healthcare claims, provider contracts, and reimbursement policies.
Responsibilities include conducting complex audits, mentoring team members, analyzing paid claims, collaborating with Engineering to develop audit tools, and ensuring compliance with CMS guidelines and HIPAA requirements. The role requires advanced proficiency in Cotiviti audit tools, Microsoft Excel, and healthcare data analysis.
The position supports the improvement of healthcare payment accuracy and contributes to healthcare quality by identifying and recovering improper payments.
- High School Diploma required; Bachelor's degree preferred.
- 4-6 years related healthcare experience.
- 3-4 years Cotiviti experience preferred.
- Knowledge of claim adjustments, provider contracts, reimbursement policies, and payment integrity.
- Proficient in Microsoft Office; SQL experience strongly preferred.
- Excellent verbal and written communication skills.
- Ability to work independently and in teams.
- Must understand HIPAA regulations and maintain data confidentiality.
- Capable of handling complex data sets and audit processes.
- Competitive benefits package including medical, dental, vision, disability, and life insurance.
- 401(k) savings plan.
- Paid family leave, 9 paid holidays, and 17-27 days of PTO annually.
- Discretionary bonus eligibility.
- Remote work opportunity.
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 week ago