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Job Summary:

The Specialist Payment Accuracy I is responsible for independently conducting complex audits on client systems, validating claim adjudications, and ensuring the accuracy and compliance practices. This role involves leading audit projects, calling multiple payers, providing actionable insights, and collaborating with management to enhance audit effectiveness and operational risk controls. The Specialist Payment Accuracy I documents detailed findings and develops recommendations to improve claim accuracy and determine primacy audit outcomes and ensure quality and consistency.

Principal Responsibilities and Essential Duties:
Calling Multiple payers to capture the required information.
Perform audits based on clients policies and procedures and identify over payments
Ensures compliance with established internal control procedures by examining operating procedures and related documentations
Collect accurate information and documents to proceed with a claim




Make sure the overpayments for claims are accurate and correct by analyzing claims and supporting documentation
Address assigned inventory to be compliant based on the client requirements.
Utilization of all possible tools and applications available to take account to the next level of resolution.
Meet the established SLAs (service level agreements) for production and quality
Update the outcome of the work or analysis in a transparent documentation.
Utilize the process SOP and stay updated with changes done with the SOPs
Improve the performance based on the feedback provided by the reporting manager / quality audit team
Exhibit behavior consistent with Cotiviti Values
Customer Driven
Team-oriented
Accountable
Open

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties

📌 Walk In Payment Accuracy Specialist Hyderabad
🏢 Cotiviti
📍 Hyderabad