Senior Payment Accuracy Specialist (COB)

About the role

A Payment Accuracy, Coordination of Benefits (COB) Senior Specialist is a member of the Coordination of Benefits Business Unit (BU). This role involves working with individuals who are covered by two or more health plans, focusing on identifying opportunities for growth, reviewing, discovering, and validating substantial data to deliver results and insights for clients.

Responsibilities

• Works with a high degree of autonomy, independently thinking and taking responsibility for individual workflow and assignments.
• Mentors all team members within the Business Unit, assisting with new hire onboarding and training.
• Collaborates with all levels of the business on assigned projects and deliverables.
• Produces knowledge as a Subject Matter Expert (SME) in auditing and business optimization and innovation.
• Develops and facilitates audit enhancements of new tools to aid in team members' ability to perform their assigned responsibilities within databases.
• Optimizes and discovers new business opportunities, recovery, and growth of the Business Unit.
• Strategizes, disseminates, and implements cross-audit concepts across the business units and client partnerships.
• Performs quality control to thoroughly validate submissions before Client exportation of team members and own work outputs.
• Understands CMS and NAIC guidelines to establish correct order of liability.
• Independently selects members in Cotiviti tools, with a full understanding of client parameters.
• Demonstrates subject matter expert-level understanding of query and filter construction to identify opportunities.
• Ensures high level of organization and can pivot as needed based on business requirements.
• Utilizes Cotiviti audit tools (Recovery Management System (RMS), COB Tracker, specific client systems) to complete member investigations.
• Creates detailed, accurate notes in Cotiviti audit tools and/or client tools throughout the member investigation process.
• Maintains compliance with regulatory guidelines and standards.
• Identifies and solves problems by identifying errors and overpayments for healthcare clients.
• Identifies opportunities for continuous improvement for efficiencies within reporting and streamline research processes.
• Ensures confidentiality and security of all data, adhering to HIPAA laws and requirements.
• Ensures a safe work environment, complying with industry standards.
• Applies learning to ensure exceptional results beyond basic standards.
• Integrates information from various sources and considers broader context to create innovation.
• Actively seeks information to understand rationale and provide exceptional results beyond basic standards.

Qualifications

• High School Diploma (Required).
• Bachelor’s degree (Preferred) and/or at least 5 years of related experience in healthcare.
• At least 2 – 3 years Cotiviti experience is recommended for individuals seeking their next opportunity internally.
• Experience in the healthcare industry, including knowledge of Coordination of Benefits.
• Computer proficiency including Microsoft Office (Word, Excel, Outlook).
• Excellent verbal and written communication skills.
• Strong interest in working with large data sets and various databases.
• Ability to work well in an individual and team environment, demonstrating self-motivation to deliver success.
• Understanding and embodying Cotiviti Core Values, Strategic Pillars, and Operations Disciplines.

Pay

Base compensation ranges from $37.75 to $39.50 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Schedule

This role is eligible for discretionary bonus consideration.

Benefits

• Competitive benefits package including medical, dental, vision, disability, and life insurance coverage.
• 401(k) savings plans.
• 9 paid holidays per year.
• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.

Date of posting: 7/10/2026

Applications are assessed on a rolling basis. We anticipate that the application window will close on 8/10/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.