Cotiviti · 17 hours ago
Payment Accuracy COB Specialist 1
United States
Full-time
Remote
Entry Level
$22.60/hr - $26/hr
2+ years expCotiviti is a company focused on Coordination of Benefits, and they are seeking a Payment Accuracy, Coordination of Benefits (COB) Specialist 1. This role involves reviewing and analyzing claims, establishing the correct order of liability, and inputting accurate recovery information using Cotiviti software tools.
Responsibilities
This individual will work under limited supervision and will be monitored for efficiency in production and quality review of assigned work
Ability to work independently and as a collaborator when the opportunities present themselves
The scope of work will entail complex member selections and multi-client impacts
Capability and comfort in running and establishing queries and filters for construction and data reports
Moderate identification for problem-solving and resolution in data. Ability to process rationale in a solution-based environment proactively
Has a thorough understanding of Centers for Medicare and Medicaid Services (CMS) and National Association of Insurance Commissioners (NAIC) guidelines to establish the correct order of liability
Utilizes Cotiviti audit tools (Recovery Management System (RMS), COB Tracker, specific client systems) to complete member investigations
Creates detail-oriented, accurate notes in Cotiviti audit tools and/or client tools throughout the member investigation
Meets or exceeds 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
Prepares and evaluates responses to client disputes both internally and externally within the Business Unit as needed
Identifies opportunities for continuous improvement for efficiencies within reporting and streamlining research processes
Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements
Has a thorough understanding of the healthcare industry, as well as proven track record of delivering results
Assures confidentiality and security of all data, adhering to all HIPAA (Health Insurance Portability and Accountability) laws and requirements. Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards
Has ability to take responsibility for outcome, whether positive or negative and apply learning as applicable
Integrates information from various sources and considers broader context
Creates innovation to enhance the standard operating rhythm finding new pathways to complete work expectations
Actively seeks information to understand rationale and provide exceptional results beyond basic standards
Qualification
Required
High School Diploma
Healthcare industry experience, 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
Understands and embodies Cotiviti Core Values, Strategic Pillars, and Operations Disciplines to achieve successful performance in completing assigned responsibilities and interactions with the Organization both internally and externally
Preferred
Bachelor's degree
At least 1- 2 years Cotiviti experience is recommended for individuals seeking their next opportunity internally
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
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.
5001-10000 employees
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)
Funding
Current Stage
Late StageLeadership Team
Adam Gilbert
Director, Interoperability Operations and Partnerships
Chris McIntyre
Sr. Program Manager, RQNC Operations
Recent News
2024-04-07
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