Specialist Payment Accuracy I

The Specialist, Payment Accuracy position is an entry level position responsible for auditing client data and generating high quality recoverable claims for the benefit of Connolly and our clients. Under direct supervision, identifies and inputs recovery claims, voids, or other over-underpayment types. Documents relevant facts, information and conclusions drawn to support the work performed so other reviewers may validate claim. Communicates audit recommendations to supervisory auditor for evaluation, verification and continuous learning.

JOB RESPONSIBILITIES
- Identifies and Enters Claims
- Under direct supervision, audits standard reports and identifies over and under payments of claims. Scope may include: quality assurance; auditing paid claims; determining whether an overpayment exists; duplicate payments; identifying incorrect contract or contract rates; Coordination of Perks; Data Mining; Medical Chart Review; Medical Necessity; Claims Adjudication. Enters the claim into Cotiviti system accurately and in accordance with standard procedures.



Can work on some simple/medium standard audit reports with support.
- Effectively utilizes Audit Tools
- Utilizes with increasing proficiency, proprietary reports, tools and systems required to perform duties with moderate guidance and direction, timely executes assigned standard reports and updates. Working proficiency with all systems and applications including internal and client tools.
- Critical Thinker
- Demonstrates adeptness in identifying errors and exceptions that result in valid claims. Has an eye for irregularities. Ability to analyze data, identify inconsistencies and formulate workable solutions. Makes logical, well-reasoned and timely decisions.
- Initiative Taker
- Shows initiative and a willingness to engage in all areas of the audit. Reaches beyond current tasks to add value to audit team. Goes the extra step to solve problems instead of waiting for someone else to solve

📌 Specialist (Pune)
🏢 Cotiviti
📍 Pune