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Cotiviti · 1 day ago

Payment Accuracy COB Specialist

United States

Full-time

Remote

Entry Level

$20/hr - $23/hr

1+ years exp

Cotiviti is a company focused on healthcare analytics, and they are seeking a Payment Accuracy, Coordination of Benefits (COB) Specialist to join their team. This role involves reviewing and analyzing claims and member data to identify recoverable claims, ensuring compliance with regulatory guidelines, and utilizing proprietary software tools for data management.

Information Technology & Services

H1B Sponsor Likely

Responsibilities

Review and analyze claims, member, and group data to identify instances of recoverable claims for the benefit of Cotiviti and our clients

Establish the correct order of liability for our clients’ members

Input accurate claim recovery information in the proprietary Cotiviti software tools

Assist with related inquiries throughout the claim recovery process

Demonstrate a strong ability to proactively develop and uphold a solid grasp of Centers for Medicare and Medicaid Services (CMS) and National Association of Insurance Commissioners (NAIC) guidelines to accurately determine liability order

Leverage Cotiviti audit tools such as the Recovery Management System (RMS), COB Tracker, and client-specific systems to conduct thorough member investigations

Create detail-oriented, accurate notes in Cotiviti audit tools and/or client tools throughout the member investigation

Meet or exceed standards of production and quality as identified by compliance and regulatory guidelines and set forth by the Team Lead and/or Manager when reviewing concept and claim identifications for the client

Prepare and evaluate responses to client disputes both internally and externally within the Business Unit as needed

Identify and solve problems by classifying errors and overpayments for our healthcare clients

Identify opportunities for continuous improvement for efficiencies within reporting and streamlining research processes

Demonstrate understanding of Cotiviti policies & procedures, and external regulatory requirements and perform duties in accordance with such regulatory requirements

Assure confidentiality and security of all data, adhering to all HIPAA laws and requirements

Demonstrate the skills, knowledge, and ability to ensure that our environment is safe, complying with industry standards

Take responsibility for outcome, whether positive or negative and apply learning as applicable

Integrate information from various sources and considers broader context

Try unique ways of doing things and test promising ideas

Actively seek information to understand rationale

Complete all responsibilities as outlined on annual Performance Plan

Complete all special projects and other duties as assigned

Qualification

Coordination of BenefitsData analysisAuditing standardsHealthcare industry experienceMicrosoft OfficeVerbal communicationWritten communicationCritical thinkingAttention to detailProblem-solving

Required

High School Diploma - Required

Excellent verbal and written communication skills

An enthusiasm for working with large datasets and diverse databases will set you up for success in this position

You thrive in both individual and team environments, showcasing self-motivation and determination to achieve success

Strong understanding of auditing standards, regulations, and industry best practices. Must be able to apply these standards consistently to ensure accurate and compliant audit processes

Ability to analyze large volumes of data, identify trends, discrepancies, and anomalies. Must have exceptional attention to detail to ensure accuracy in financial records and audit findings

Demonstrates strong critical thinking skills, with the ability to assess complex situations, identify key issues, and propose practical solutions. Able to approach challenges methodically and with a strategic mindset

Makes informed decisions based on available data, regulations, and auditing standards. Must be able to weigh options and make recommendations that align with both compliance requirements and organizational goals

Ability to recognize when something is wrong or needs further investigation. Must have the initiative to probe deeper into financial records or processes to uncover issues, inconsistencies, or irregularities

Must be able to perform duties with or without reasonable accommodation

Preferred

Bachelor's degree (Preferred) and/or a minimum of one (1) year of related experience in healthcare

At least 1-year Cotiviti experience is recommended for individuals seeking their next opportunity internally. (Example: Retrieval Agent and/or Audit Support positions)

Healthcare industry experience, including knowledge of Coordination of Benefits (Preferred)

Computer proficiency including Microsoft office (Word, Excel, Outlook)

Benefits

Medical

Dental

Vision

Disability

Life insurance coverage

401(k) savings plans

Paid family leave

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.

Company

Cotiviti

Glassdoor3.7

Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States.

Founded in 1979

South Jordan, UT, US

5001-10000 employees

http://www.cotiviti.com

H1B Sponsorship

Cotiviti has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (165)

2024 (118)

2023 (90)

2022 (102)

2021 (72)

2020 (67)