Cotiviti Healthcare is seeking a Payment Accuracy Specialist II to join its healthcare recovery team. This role supports payment integrity initiatives by developing audit concepts, reviewing claims and client data, identifying overpayments or underpayments, and producing high-quality recoverable claims.
The position works within the Data Mining business unit and focuses on claim reviews, contract compliance, reimbursement analysis, quality assurance, and concept development. The specialist also supports training, knowledge sharing, and process improvement efforts, and may collaborate with engineering on reporting and tool enhancements.
Requirements & Qualifications
Qualifications
- High school diploma required
- Bachelor's degree preferred
- 4-6 years of related healthcare experience
- 3-4 years of Cotiviti experience recommended for internal candidates
- Healthcare industry experience with claim adjustments, provider contracts, reimbursement policies, and payment integrity strongly preferred
- Proficiency with Microsoft Office, especially Excel
- Previous SQL experience strongly preferred
- Strong verbal and written communication skills
- Ability to work with large data sets and databases
- Strong attention to detail, critical thinking, and decision-making skills
- Ability to work independently and collaboratively
- Understanding of auditing standards, regulations, and best practices
- Ability to identify discrepancies, trends, and anomalies
- Experience with CMS and NAIC guidelines preferred
- Familiarity with recovery management systems, client systems, and audit tools preferred
Benefits & Perks
Benefits
- Medical, dental, and vision insurance
- Disability and life insurance
- 401(k) savings plan
- Paid family leave
- 9 paid holidays per year
- 17-27 days of PTO per year depending on level and tenure
- Eligible for discretionary bonus consideration
- Nonexempt role eligible for overtime pay
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago