Job Details
Description
Cotiviti Healthcare is the payment accuracy expert! We work with healthcare organizations to recover money, improve processes, strengthen relationships and maximize their value. We are a fast growing and highly successful payment integrity firm with a long history of success. As we continue to grow, we are seeking experienced Payment Accuracy Specialist II to join our team. This is a great opportunity to join a well-established company with competitive pay, opportunities to develop professionally and excellent benefits.
For the safety of our employees and those considering employment with Cotiviti, we are currently conducting all interviews virtually. In addition, the majority of the Cotiviti team is currently working remotely, and we are onboarding new hires remotely as well. As we monitor the pandemic, these arrangements may change and we will update accordingly.
Job Responsibilities
As a successful Payment Accuracy Specialist II, you will identify, develop, and implement new concepts that will recognize incorrect payments. Concepts are developed based on your industry experience, regulatory research, and your ability to analyze medical claim data to discover incorrect payments. You will be responsible for analyzing client data and generating high quality recoverable claims for the benefit of Cotiviti and our clients. You will assist in the identification, validation and documentation of moderate to more complex recovery projects. You will also be responsible for executing more independent projects assigned by your Operations Manager. If you are successful at thinking “outside of the boxâ€, very analytical and love problem/puzzle solving complex medical claims, then look no further, review the position and requirements below and apply now!
Other responsibilities of the Payment Accuracy Specialist II role include:
Utilizing healthcare experience to perform audit recovery procedures
Identifying and validating incorrect claim payments
Identifying and defining issues, developing criteria, reviewing and analyzing contracts and Health Plan reimbursement regulations
Entering and documenting the incorrect payment issue into Cotiviti’s systems accurately and in accordance with standard procedures
Updating and developing new and current audit recovery reports, developing and running custom queries
Researching reimbursement regulations for claim payment compliance reviews and documentation to support current audit findings
As a Payment Accuracy Specialist II – you must have a passion for solving complex medical claim reimbursement problems. You must be an independent thinker with a great attention to detail. You must be a self-disciplined team player who enjoys working in a collaborative environment. Qualified candidates have the ability to multitask, set priorities and meet deadlines.
Requirements:
Bachelor’s Degree preferred
Minimum 3 year’s knowledge of direct claim processing/reimbursement, medical facility contracts, fee schedules, inpatient/outpatient/physician claims or strong data analytics experience required
Medicare experience strong preferred
Certified Professional / Hospital Coder Certification (CCS, CPC, CPC-H, CCS-P, CCRC, CCS-A, RHIA, RHIT ) preferred
Prior claims auditing or consulting experience desirable in either a provider or payer environment
Excellent communication skills both oral and written
Strong interpersonal skills that will support collaborative team work
Microsoft Office Proficient: Word and Excel; Access – highly preferred
Our most important resource at Cotiviti is our dedicated staff of professionals. Joining the Cotiviti team means being welcomed into a collaborative, team-oriented environment. Our open and supportive culture encourages employee contributions that enable individual success and professional development. Our team thrives on a passion for success and creative independence.
