Cotiviti · 4 days ago
Payment Integrity Specialist
United States
Full-time
Remote
Mid, Senior Level
5+ years expCotiviti is a company focused on healthcare payment integrity, and they are seeking a Payment Integrity Specialist to provide claims audit and recovery services. The role involves auditing healthcare claims, reviewing clinical documentation, and supporting business development activities.
Information Technology & Services
Responsibilities
Audit healthcare claims on behalf of our private health insurance clients to detect and recover overpayment
Review clinical documentations submitted by providers
Provide insights into hospital billing practices that will improve the Company’s ability to detect and recover overpayments
Support the growth of the Payment Integrity Practice by supporting business development activities
Strictly respect the confidentiality of all sensitive company and client information
Qualification
Required
Bachelor's Degree (Nursing or equivalent) with experience in Critical care, emergency department or operating theatre experience preferred
Health Information Manager
Clinical coder with a coding qualification with 5-8 years' experience
Experience in auditing private hospital claims
Understanding of private health insurance legislation and private hospital funding models
Experience working in the private health insurance sector or in private hospital audit
Excellent written and verbal communication skills
Effective time management, planning and organizational skills
Ability to work remotely from home
Preferred
Clinical coding experience highly desired
Familiarity with 3M codefinder
Maintain knowledge and expertise by attending appropriate educational sessions
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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