Cotiviti · 17 hours ago
Team Lead, Payment Accuracy (Data Mining)
United States
Full-time
Remote
Mid, Senior Level
$80K/yr - $95K/yr
4+ years expCotiviti Healthcare is the payment accuracy expert! They are seeking a Senior Payment Accuracy Specialist to lead a team within an audit engagement, mentoring and developing less tenured team members while analyzing medical claim data to identify incorrect payments.
Responsibilities
Utilizing healthcare experience to perform audit recovery procedures
Identifying and validating incorrect claim payments
Identifying and defining issues, developing criteria, reviewing and analyzing contracts and Health Plan reimbursement regulations
Entering and documenting the incorrect payment issue into Cotiviti’s systems accurately and in accordance with standard procedures
Updating and developing new and current audit recovery reports, developing and running custom queries
Researching reimbursement regulations for claim payment compliance reviews and documentation to support current audit findings
Qualification
Required
4+ year's knowledge of direct claim processing/reimbursement, medical facility contracts, fee schedules, inpatient/outpatient/physician Claims required
Excellent communication skills both oral and written
Strong interpersonal skills that will support collaborative team work
Preferred
Bachelor's Degree preferred
Certified Professional / Hospital Coder Certification (CCS, CPC, CPC-H, CCS-P, CCRC, CCS-A, RHIA, RHIT ) preferred
Microsoft Office Proficient: Word and Excel; Access – highly preferred
Prior claims auditing or consulting experience desirable in either a provider or payer environment
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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