CotivitiCO

Audit Support COB and DM

Cotiviti is a solutions and analytics company that leverages clinical and financial datasets to provide insights into the performance of the healthcare system, focusing on payment accuracy, risk adjustment, quality improvement, and consumer engagement. It also serves the retail industry with data management and recovery audit services.

Cotiviti

Employee count: 5000+

Salary: 35k-39k USD

United States only

Overview

The Coordination of Benefits (COB) & Data Mining (DM) Audit Support is a member of the greater Coordination of Benefits and Data Mining Business Units (BUs.) This individual will efficiently and professionally handle daily administrative activities within the COB and DM departments to assist the audit to meet and exceed client expectations. This role requires exceptional verbal communication by audio as well as attentive attention to detail for data entry-related written communication and follow–ups for both internal and external client inquiries to achieve success in the generation of overpayments.

Responsibilities

  • This individual will work under the direct supervision of a Team Lead and/or Manager.
  • Partners with all levels and members of the COB & DM auditing team to provide a variety of support and general task-based assignments in support of the business objectives and goals for the calendar year.
  • Communicates directly with Medicare, Insurance companies, Providers, and/or Employer groups to obtain pertinent member eligibility details that will impact the correct order of member liability.
  • Enters accurate member, group, and claim information into Cotiviti tools (Recovery Management Systems, SharePoint, COB Tracker, Client Systems).
  • Ensures 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.
  • Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements.
  • Meet or exceeds standards for productivity and quality as identified by guidelines as set forth by the Team Lead and/or Manager.
  • Complete all responsibilities as outlined on annual Performance Plan.
  • Complete all special projects and other duties as assigned.
  • Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications

  • High School Diploma or General Educational Development (GED) Required.
  • 0 –1 years of prior experience.
  • At least 1 year of Cotiviti experience is recommended for individuals seeking their next opportunity internally. (Example: Retrieval Agent)
  • Prior experience in an administrative support function and/or office environment (preferred).
  • Computer proficiency in Microsoft Office applications.
  • Excellent verbal and written communication skills.
  • Ability to work well in an individual and team environment demonstrating self-motivation to deliver success.
  • Strong attention to detail in documentation and review of information.
  • Understands and embodies Cotiviti’s Core Values, Strategic Pillars, and Operational Disciplines to achieve successful performance in completing assigned responsibilities and interactions with the Organization both internally and externally.

Mental Requirements:

  • Must have strong emotional intelligence to understand and respond to the needs of customers with empathy and respect.
  • Ability to manage stress in a fast-paced or high-pressure environment. Demonstrates resilience and maintains composure when handling multiple tasks or facing unexpected challenges.
  • Strong attention to detail, with the ability to identify errors and ensure accuracy in tasks such as data entry, documentation, and communication.
  • Strong verbal and written communication skills to effectively convey information to colleagues and clients. Must be able to adjust communication style depending on the audience.
  • Ability to adapt to changes in workflows, new systems, or unexpected situations. Must be flexible in adjusting priorities and tasks based on shifting demands.
  • Must be able to prioritize and manage time effectively, balancing multiple tasks and meeting deadlines. Organizational skills are necessary to stay on top of tasks and responsibilities.
  • Must maintain confidentiality and act with professionalism when handling sensitive information, ensuring compliance with organizational policies and privacy standards.
  • Demonstrated ability to maintain a positive, customer-focused attitude in all interactions, with a focus on delivering high-quality service and ensuring customer satisfaction.

Physical Requirements and Working Conditions:

  • Remaining in a stationary position, often standing or sitting for prolonged periods.
  • Communicating with others to exchange information.
  • Repeating motions that may include the wrists, hands and/or fingers.
  • Assessing the accuracy, neatness and thoroughness of the work assigned.
  • No adverse environmental conditions expected.
  • Must be able to provide a dedicated, secure work area.
  • Must be able to provide high-speed internet access / connectivity and office setup and maintenance.

Base compensation ranges from $17.50 per hour to $19.60 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 4/23/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 4/30/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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About the job

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Posted on

Job type

Full Time

Experience level

Mid-level

Salary

Salary: 35k-39k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Cotiviti

Learn more about Cotiviti and their company culture.

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Through groundbreaking technology and profound data analytics, Cotiviti is revolutionizing the economics of healthcare. The company is at the forefront of enabling healthcare organizations to deliver enhanced care at a reduced cost, thereby ensuring the quality and sustainability of the healthcare system in the United States. Cotiviti's innovative solutions are a critical foundation for healthcare payers, empowering them in their mission to lower healthcare expenditures and elevate quality through higher-performing payment accuracy, risk adjustment, quality improvement, and consumer engagement programs. By processing and analyzing billions of clinical and financial data points, Cotiviti uncovers opportunities for clients to boost efficiency and quality, ultimately leading to better care for their members. The company's commitment to responsible AI implementation is evident in its partnership with the Responsible AI Institute, aiming to develop new ways to leverage artificial intelligence to foster a high-quality and viable healthcare system. This focus on accelerating the development of innovative healthcare technologies drives advancements in data analytics, interoperability, and value-based care solutions.

Cotiviti's expertise extends to serving the retail industry with sophisticated data management and recovery audit services designed to improve business outcomes. The company's approach is rooted in a combination of advanced technology, comprehensive data analytics, and specialized expertise. This synergy allows Cotiviti to provide solutions that address payment accuracy, quality improvement, risk adjustment, and network performance management. Cotiviti's dedication to innovation is further highlighted by its recent technological advancements, such as 360 Pattern Review, which utilizes artificial intelligence to rapidly identify potential healthcare fraud, waste, and abuse, and Zero Hour Alerts, which empowers large retailers to prevent payment errors. With a global team of over 9,000 employees, Cotiviti fosters a collaborative environment where specialized and talented teams work in tandem to ensure operational efficiency and deliver services that exceed industry standards. The company's vision is to enable a high-quality and viable healthcare system, and its mission is to improve this system through its unique blend of technology, analytics, and expertise.

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Cotiviti hiring Audit Support COB and DM • Remote (Work from Home) | Himalayas