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Cotiviti

Catches billing errors for health insurers

Senior Revenue Integrity Analyst

Accounts Payable/ReceivableConfirmed live in the last 24 hours
Full-timeRemote in USA$80k - $95k /yr

About the Job

Requirements

  • A bachelor's degree in Accounting, Finance, Economics, Business Administration, Engineering, Computer Science, Mathematics, Statistics, or a related field, or an equivalent combination of education, professional training, and relevant work experience; a high school diploma or GED is required.
  • Five to eight years of experience in finance, accounting, healthcare payment integrity, revenue cycle, or related fields.
  • Strong experience in revenue integrity, revenue cycle management, invoice standards, financial and accounting best practices, inventory management, healthcare payment integrity, and healthcare claims processing.
  • Ability to own multistep month-end controls and resolve complex discrepancies across client-supplied files, invoice detail, and internal financial systems.
  • Advanced Excel and data-analysis skills, with proficiency developing reports and insights in Power BI or similar business intelligence tools.
  • Working knowledge of healthcare payment integrity, claims processing, finance and accounting, and billing cycles.
  • Ability to interpret client-specific invoicing logic and contractual requirements and communicate findings to internal and external stakeholders.
  • Experience collaborating across Finance, Operations, Technology, Engineering, and client-facing teams to implement corrective actions.
  • Ability to interpret complex transactional, financial, contractual, and inventory data; isolate root causes; determine appropriate corrective actions; communicate findings; complete complex analyses independently; escalate material risks and decisions; make timely workflow decisions; manage recurring deliverables and deadlines; assess reconciliation and reporting accuracy; and learn and apply new systems, processes, contract terms, and automation approaches.
  • Must be able to perform duties with or without reasonable accommodation.
  • Must be able to provide a dedicated, secure work area and high-speed internet access, connectivity, and office setup and maintenance.

Responsibilities

  • Own month-end revenue validation controls, including reconciliation of outputs, exceptions, adjustments, open inventory, and close support schedules.
  • Investigate potentially missed, delayed, misstated, or incorrectly billed revenue using paid claim transactional data, invoice detail, contractual terms, and internal financial records; compare disparate data sources to uncover and apply missed opportunity.
  • Perform and oversee reconciliation of client self-billing files, including data transformation, loading, quality verification, exception analysis, and final invoice support.
  • Review invoicing accuracy and contract alignment; apply non-standard contractual pricing; resolve discrepancies, disputes, and fee paybacks; and support appropriate closure of inventory.
  • Analyze period-over-period movement, inventory aging, throughput, financial data, and other financial variances.
  • Identify root causes of financial underperformance and communicate findings, revenue impact, options, and recommended corrective actions in formal business settings.
  • Lead invoice-detail questions and escalations with internal and external stakeholders, and prepare facts and resolution recommendations for complex client issues.
  • Develop recurring reports, dashboards, forecasts, and insights as needed to monitor key performance indicator and service-level agreement performance, revenue risk, service delivery, and financial accuracy.
  • Partner with Finance, Operations, Technology, and Engineering to reconcile inventory and correct invoicing or revenue-application system and process issues.
  • Use Power BI, automation, and agentic tools to improve analytical quality, control effectiveness, cycle time, and operating efficiency.
  • Mentor junior analysts and establish consistent approaches for reconciliations, investigations, documentation, and escalation.
  • Complete responsibilities outlined in the annual performance review or goal setting, as well as special projects and other duties as assigned.

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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