Payment Accuracy Specialist 2 (Healthcare)

About the role

Cotiviti Healthcare is seeking a Payment Accuracy Specialist 2 to join our Data Mining team. This role involves developing and executing audit projects, training colleagues, and ensuring the quality of audit findings.

Responsibilities

• Develop and execute audit projects, building relationships with clients and training junior team members.
• Utilize healthcare experience to identify and define billing compliance issues, and document findings for training and knowledge sharing.
• Work with engineering to improve audit tools and reports, and validate the accuracy of current reports.
• Make determinations based on client contract terms and complex claim types, and respond to inquiries and disputes.
• Collaborate with Engineering to develop new reports and tool functionality, and ensure adherence to regulatory requirements.
• Identify new claim types and concept expansion, and recommend new audit concepts and processes.
• Ensure confidentiality and security of all data, adhering to HIPAA laws and industry standards.

Qualifications

• High School Diploma - Required.
• Bachelor’s degree (Preferred) and/or at least 4-6 years of related experience in healthcare.
• At least 3-4 years of Cotiviti experience recommended for internal candidates.
• Experience in healthcare industry, including claim adjustments, provider contracts, reimbursement policies, and payment integrity.
• Computer proficiency, including Microsoft Office (Word, Excel, Outlook, Access).
• Previous SQL experience strongly preferred.
• Excellent verbal and written communication skills.
• Strong interest in working with large data sets and various databases.
• Ability to work independently and as part of a team, demonstrating self-motivation and dedication.

Benefits

The base compensation ranges from $29.00 to $33.00 per hour, with specific offers determined by various factors. This role is eligible for discretionary bonus consideration. Cotiviti offers a competitive benefits package including medical, dental, vision, disability, life insurance, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year.