Get Paid $4,083.33 – $5,166.67 per Month to Evaluation & Enter Claims from Residence!

Fee Accuracy Specialist 1
Job LocationsUS-Distant
ID2023-9756
Class Audit – Healthcare
Place Kind Full-Time

Overview

Cotiviti Healthcare is a number one supplier of fee accuracy providers to essentially the most acknowledged corporations within the healthcare and retail industries. We’re looking for progressive thinkers and artistic drawback solvers who’re desirous about making a contribution to bettering healthcare and need to be a part of a crew that’s increasing quickly and offering alternatives for profession progress. If you wish to make a distinction and contribute to the development of healthcare fee integrity, take into account a chance to affix our healthcare restoration crew as a Fee Accuracy Specialist.

The Fee Accuracy Specialist 1 place is chargeable for auditing shopper information on behalf of Cotiviti’s shoppers and producing prime quality recoverable claims for the good thing about Cotiviti and our shoppers, in addition to conducting or helping within the identification, validation and documentation of average to extra complicated audit tasks. This function will likely be primarily chargeable for auditing efforts by executing extra impartial tasks, low to mid vary in scope assigned by the Audit Supervisor.

For the security of our workers and people contemplating employment with Cotiviti, we’re at present conducting all interviews just about. As well as, the vast majority of the Cotiviti crew is at present working remotely, and we’re onboarding new hires remotely as nicely. As we monitor the pandemic, these preparations could change and we are going to replace accordingly.

Duties

• Determine and Enter Claims. Makes use of healthcare expertise to carry out audit procedures that embrace figuring out and defining points, growing standards, reviewing and analyzing proof with the intent to audit normal medium and complicated stories. Determine and validate over and below funds of claims. Work is average in scope and complexity. Data is utilized to resolve routine points, as crucial. Scope could embrace: auditing paid transactions; figuring out whether or not an overpayment exists; figuring out incorrect deductions; information mining. Enters the declare into Cotiviti system precisely and in accordance with normal procedures. Determine and focus on audit findings with audit crew and doc exceptions.

• Successfully Make the most of Audit Instruments. Make the most of and exhibit with consistency, Cotiviti and shopper instruments required to carry out duties. Enter the declare into Cotiviti system precisely and in accordance with normal procedures. Upon proficiency with techniques instruments, could replace present stories, develops and runs customized queries and validate accuracy of present stories used. Make determinations based mostly on prior information, expertise of shopper contract phrases with the probability of restoration acceptance.

• Meet or Exceed Requirements/Pointers for Productiveness. Along with common and predictable attendance, keep manufacturing objectives and high quality requirements set by the audit for the auditing idea. Audits in opposition to the usual anticipated degree of high quality and amount (i.e. charges per hour, vendor/undertaking quantity completion, claims written).

• Meet or Exceed Requirements/Pointers for High quality. Obtain the usual degree of high quality set by the audit for the auditing idea, for legitimate declare identification and documentation. Contributes in choices on audit work accomplished after the assorted prospects have been thought-about.

• Put together Response to Consumer and Provider Disputes. Reply to shopper/Provider disputes for claims written. Present verification of claims validation and affirmation, in a concise written method.

• New Rent Help. Take part within the on-boarding of workers new to the audit. Ready to evaluate audit instruments, shopper particular terminology and other people assets together with colleagues, shoppers, and different stakeholders.

• Advocate New Ideas and Processes. Leverages information of shopper, contract phrases and complicated declare sorts. Works in the direction of growing and implementing new concepts approaches and/or technological enhancements that may assist and improve audit manufacturing, communication and shopper satisfaction. Evaluates data and attracts logical conclusions. Makes use of discovered, tried and confirmed validation strategies to check and produce a desired or meant results of the brand new ideas. Could collaborate with Enterprise Optimization in growing new stories.

{Qualifications}

• One (1) yr of Cotiviti direct audit expertise OR two (2) years associated expertise (healthcare billing, healthcare/medical claims, reimbursement, analytics) required.

• Bachelors diploma strongly most well-liked.

• Sturdy working information and understanding of healthcare industries most well-liked.

• Confirmed analytic expertise utilizing Microsoft Excel, Entry database question capabilities and skill to evaluate information at numerous ranges of element.

• Investigative abilities, together with the flexibility to guage information and evidences to attract conclusions, even when data is restricted in addition to clarify issues or conditions utilizing a scientific framework

• Sturdy communication abilities, together with means to construct relationships and articulate ideas clearly and successfully.

• Potential to reach a incessantly altering and unstructured setting and take care of ambiguity.

• Group participant that works collaboratively with numerous crew members to perform built-in options.

Cotiviti is an equal employment alternative employer. Cotiviti recruits, hires and promotes people based mostly on their {qualifications} for a particular job. Cotiviti values its numerous workforce and its choice of workers is made with out regard to race, coloration, creed, intercourse, age, faith, being pregnant, childbirth or pregnancy-related circumstances, nationwide origin, sexual orientation, marital standing, genetic provider standing, navy service, veteran standing, incapacity, or some other class of sophistication protected by federal, state or native legal guidelines. All employment choices and personnel actions, equivalent to hiring, promotion, compensation, advantages, and termination, are and can proceed to be administered in accordance with, and to additional the precept of, equal employment alternative.

Pay Transparency Nondiscrimination Provision
Cotiviti won’t discharge or in any method discriminate in opposition to workers or candidates as a result of they’ve inquired about, mentioned, or disclosed their very own pay or the pay of one other worker or applicant. Nevertheless, workers who’ve entry to the compensation data of different workers or candidates as a part of their important job capabilities can not disclose the pay of different workers or candidates to people who don’t in any other case have entry to compensation data, until the disclosure is (a) in response to a proper criticism or cost, (b) in furtherance of an investigation, continuing listening to, or motion, together with an investigation performed by the employer, or (c) according to the contractor’s authorized obligation to furnish data. 41 CFR 60-I.35(c)

** This function will get paid an estimated $49,000 – $62,000 a yr.