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Cotiviti

Catches billing errors for health insurers

Auditor Retail

AccountingConfirmed live in the last 24 hours
Full-timeMexico City, CDMX, Mexico

About the Job

Requirements

  • A bachelor's degree in Finance, Accounting, and/or Business Administration, or at least four years of equivalent experience is required.
  • Computer proficiency in Microsoft Office, including Word, Excel, and Outlook, is required.
  • A strong interest in working with large data sets and various databases is required.
  • Excellent verbal and written communication skills are required.
  • Strong English speaking and writing skills are required.

Responsibilities

  • Under direct supervision, audit standard reports and smaller or lower-profile project-based routines to identify overpayments and underpayments of claims.
  • Audit paid claims, determine whether overpayment exists, identify duplicate payments, identify incorrect contracts or contract rates, and perform data mining as assigned.
  • Enter claims accurately into the Cotiviti system in accordance with standard procedures.
  • Work on less complex and medium standard audit reports with support, including reviewing and documenting claim potentials identified by auditors and senior auditors.
  • Use proprietary reports, tools, and systems required to perform duties with increasing proficiency.
  • Execute assigned standard reports and updates in a timely manner with moderate guidance and direction.
  • Use all systems and applications, including Decipher and client tools, with working proficiency.
  • Maintain production goals and quality standards set for the auditing concept.
  • Meet expected quality and quantity levels, including fees per hour, vendor or project volume completion, and claims written.
  • Respond to client or vendor disputes and internal quality assurance inquiries for claims written.
  • Provide concise written and oral verification of claims validation.
  • Develop proficiency in transaction types, client contracts and vendor agreements, and client data to identify potential overpayments and underpayments.
  • Complete all responsibilities outlined in the annual Performance Plan.
  • Complete special projects and other duties as assigned.
  • Perform duties with or without reasonable accommodation.

Desired Qualifications

  • Proficiency in Microsoft Access is preferred.
  • Retail industry experience is desired.

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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