Payment Accuracy Specialist

Job Summary

Seeking a full-time Payment Accuracy Specialist, this role will audit client data and generate recoverable claims while working closely with the Data Mining Business Unit to ensure compliance with billing regulations and policies.

Key responsibilities

• Conduct audits of client data to identify over and under-payments, documenting findings and sharing knowledge within the audit team
• Utilize Cotiviti audit tools and Microsoft Excel to analyze reports and ensure accuracy in claim identification and documentation
• Participate in onboarding and cross-training efforts while recommending process improvements and new auditing concepts

Required qualifications

• High School Diploma required; Bachelor's degree preferred with 2-4 years of related healthcare experience
• Healthcare industry experience, particularly with Medicaid claims, is strongly preferred
• Proficiency in Microsoft Office applications, especially Excel
• Strong analytical skills with the ability to assess complex data and identify trends
• Experience with auditing standards and regulations, ensuring compliance in audit processes