The Sr. Audit Support Assistant (Repricing Team) position efficiently and professionally handles more complex, broad daily administrative activities within the audit engagement. Responsibilities include providing claim level review of payment methodology, investigating claim payment discrepancy and coding mismatches, and performing re-calculation of claim payments based on audit results. This role will support the auditing team in determining the value of their finding and may engage in basic audit activities under the direct supervision of an audit professional.
Key Responsibilities:
Provides Specialized Administrative Support - Performs more focused or complex support and administrative assignments for the audit, including file management, data management, Review provider contracts, apply appropriate payment methodology, apply outcome/closure status.
Generates and Analyzes Reports - Generate report to analyze trends in closed claims to provide feedback to the appropriate department.
Proof Claim Information - Provides detailed proofing support on claims submittals to ensure accuracy of totals, verbiage, calculations or other key variables prior to client submission.
Meets or Exceeds Standards for Productivity - Maintains productivity goals and standards set by the department. Insures all department rules and processes are followed. Alerts manager of system issues or other issues impacting productivity.
Meets or Exceeds Standards for Quality - Achieves the expected level of quality set by the department. Verifies completeness and accuracy of work. Alerts manager of issues or concerns impacting quality of work.
Requirements:
High School graduate or equivalent education, Bachelor's degree preferred.
3+ years administrative support required.
3+ years' medical billing and provider reimbursement experience preferred
Computer proficiency in Microsoft Office applications and system databases are required.
Requires working knowledge of and applicable industry based standards.
Excellent verbal and written communication skills.
Ability to work well in an individual and team environment.
Job Demands:
For the safety of our employees and those considering employment with Cotiviti, we are currently conducting all interviews virtually. In addition, the majority of the Cotiviti team is currently working remotely, and we are onboarding new hires remotely as well. As we monitor the pandemic, these arrangements may change and we will update accordingly.
This position is work from home...in the US. Access to high speed internet is required (all other equipment will be provided).
Must be able to sit and use a computer keyboard for extended periods of time
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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
