Cotiviti Healthcare is seeking a Payment Accuracy Specialist 1 to join its healthcare recovery team. This role supports the Data Mining Business Unit by auditing client data, identifying overpayments and underpayments, and documenting findings for recoverable claims. The position involves working on moderate to complex audit projects, using audit tools and client systems, and collaborating with the audit team to improve payment integrity and support concept expansion.
Key responsibilities include:
- Auditing standard reports and paid claims to identify payment discrepancies
- Validating and documenting audit findings with supporting facts and conclusions
- Entering overpayments accurately into Cotiviti systems
- Reviewing contract terms, client data, and reimbursement methodologies
- Supporting onboarding and cross-training efforts
- Identifying new claim concepts and process improvements
- Maintaining compliance with HIPAA and other regulatory requirements
Requirements & Qualifications
Qualifications
- High school diploma required
- Bachelor's degree preferred
- 2-4 years of related healthcare experience preferred
- Healthcare industry experience, including Medicaid claims knowledge, strongly preferred
- Proficiency with Microsoft Office, especially Excel
- Strong verbal and written communication skills
- Ability to work with large data sets and databases
- Ability to work independently and in a team environment
Cognitive and work requirements
- Analyze large volumes of data to identify trends, discrepancies, and anomalies
- Apply critical thinking to complex audit situations
- Make informed decisions based on data, regulations, and auditing standards
- Recognize issues that require deeper investigation
- Collaborate effectively with audit team members
- Manage multiple tasks and maintain productivity and quality standards
Benefits & Perks
Benefits
- Medical, dental, and vision insurance
- Disability and life insurance coverage
- 401(k) savings plan
- Paid family leave
- 9 paid holidays per year
- 17-27 days of PTO per year, depending on level and length of service
- Discretionary bonus consideration
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 weeks ago