Payment Accuracy COB Specialist

• Collaborates with all levels of the business upon assigned projects and deliverables
• Produces knowledge as a Subject Matter Expert (SME) providing knowledge share to Specialists
• Introduces new ideas, research, and creative thinking
• Operates with the distribution of inventory and isolate to designate filters and queries
• Works with multi-clients to produce impact and outcomes
• Has an in-depth understanding of CMS and NAIC guidelines
• Demonstrates advanced level of understanding of query and filter construction
• Utilizes Cotiviti audit tools to complete member investigations
• Creates detail-oriented, accurate notes in Cotiviti audit tools
• Prepares and evaluates responses to client disputes
• Identifies and solves problems by identifying errors and overpayments

Requirements

• High School Diploma Required
• Bachelor’s degree (Preferred)
• Minimum of at least 2-4 years related experience in healthcare
• At least 1-2 years Cotiviti experience recommended
• Healthcare industry experience, including knowledge of Coordination of Benefits
• Computer proficiency including Microsoft Office (Word, Excel, Outlook)
• Excellent verbal and written communication skills
• Strong interest in working with large data sets and various databases

Core Competencies

Demonstrates expertise in healthcare operations, particularly in Coordination of Benefits and Cotiviti audit tools, while effectively collaborating with diverse teams to drive impactful outcomes. Possesses strong analytical skills for problem-solving and data management.

Highest-signal resume keywords

• Cotiviti Experience
• Healthcare Industry Knowledge
• Query and Filter Construction
• Data Analysis
• Communication Skills

ATS Optimization Keywords

Hard Skills

• Query Construction
• Filter Construction
• Data Analysis
• Knowledge of CMS Guidelines
• Knowledge of NAIC Guidelines
• Coordination of Benefits
• Detail-Oriented Note Creation
• Problem Identification
• Error DetectionOverpayment Resolution

Soft Skills

• Collaboration
• Creative Thinking
• Verbal Communication
• Written Communication
• Problem Solving

Industry Keywords

• Healthcare
• Client Disputes
• Inventory Distribution
• Member Investigations
• Data Sets

Tools & Technologies

• Cotiviti Audit Tools
• Microsoft Office
• Excel
• Word
• Outlook