Payment Accuracy COB Specialist

Job Summary

Working full-time in a remote capacity, the Payment Accuracy COB Specialist will review and analyze claims and member data to identify recoverable claims while utilizing proprietary software tools and adhering to compliance guidelines.

Key responsibilities

• Review and analyze claims and member data to establish correct order of liability and identify recoverable claims
• Utilize Cotiviti audit tools to conduct thorough member investigations and document findings accurately
• Prepare responses to client disputes and identify opportunities for process improvements within the claim recovery workflow

Required qualifications

• High School Diploma is required; Bachelor's degree and/or related healthcare experience preferred
• Minimum of one year of experience in the healthcare industry, with knowledge of Coordination of Benefits preferred
• Proficiency in Microsoft Office applications, including Word, Excel, and Outlook
• Experience with large datasets and a strong analytical mindset to identify trends and discrepancies
• Familiarity with CMS and NAIC guidelines related to healthcare claims