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Cotiviti

Catches billing errors for health insurers

Client Services Manager Clinical Chart Validation

Account ManagementConfirmed live in the last 24 hours
Full-timeRemote in USA$86k - $113k /yr

About the Job

Requirements

  • Develop strong professional relationships with multiple roles and levels.
  • Have strong organizational and planning skills for project management.
  • Understand healthcare claims adjudication and support processes.
  • Be proficient with Microsoft Office Suite, including Word, Excel, and PowerPoint.
  • Be able to work within a matrix organization and handle confidential information appropriately.
  • Be able to work independently and in a team environment, manage multiple tasks, prioritize, and meet deadlines.
  • Have excellent written and verbal communication skills, including public speaking.
  • Have a bachelor's degree in a related area, including but not limited to Health Information Management, Nursing, or Management.
  • Have at least four years of related healthcare experience, including operations experience in healthcare consulting, provider relations, network management, or claims operations.
  • Have at least one year of related project management experience, including management of client deliverables.
  • Have excellent presentation skills, including the ability to present and interact at the C-level with internal stakeholders, clients, and providers.
  • Be able to provide a dedicated, secure work area and high-speed internet access/connectivity with office setup and maintenance.

Responsibilities

  • Manage operational execution of the auditing program in coordination with client operational managers, provider services managers, network managers, claims managers, member services managers, and IT managers.
  • Work with the Senior Client Services Manager and Director, Client Services as a primary account manager for all levels of client contacts for large and/or multiple accounts; identify important trends by monitoring and investigating processing and financial/savings data; communicate findings internally and externally through formal processes; and execute action plans where necessary.
  • Develop, contribute to, and/or manage projects, process improvements, and strategic initiatives involving cross-functional and cross-company teams, including provider/payer communication efforts, Cotiviti and client systems, and miscellaneous client requests.
  • Act as the client's subject matter expert for all Cotiviti-related activities.
  • Present operational results to client and internal contacts at all levels during regularly scheduled meetings.
  • Work regularly with Cotiviti and client operational teams on all open action items.
  • Assist with the design and communication of client-facing reporting specific to each client.
  • Assist in identifying and creating solutions for invoicing challenges and ensure client-specific production metrics and expectations are achieved.
  • Participate in strategic initiatives for the business.
  • Coordinate onsite provider and client visits and communicate key objectives to the operational team.
  • Participate in the sales process to help ensure contract-term expectations result in a successful client experience.

About the Company

Cotiviti

Catches billing errors for health insurers

Cotiviti sells software and review services that help US health insurers pay medical claims correctly, catch fraud, and track the quality of care their members receive. Its software for HEDIS, the care-quality scores US health plans report, has passed certification by the nonprofit NCQA every year since 2001. Insurers run claims through its coding and payment-policy checks before paying them, while its auditors review medical records and paid claims to recover overpayments. Clients pay it software fees or a share of the savings it finds. Cotiviti began in 1979 by auditing retailers' payments to suppliers, which it still does, and it is based in South Jordan, Utah, and owned by private equity firms Veritas Capital and KKR.

Company size
5,001-10,000
Company stage
IPO
Headquarters
South Jordan, UT
Founded
1979

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