Role & Responsibilities
Call multiple US healthcare payers/providers to collect and validate required claim information.
Access client applications and review relevant claim information.
Audit claims and EOBs to identify incorrect or overpaid claims.
Perform audits based on client policies, procedures, and SOPs.
Analyze claims and supporting documents to validate overpayments.
Collect accurate information and documentation required for claim resolution.
Maintain transparent and accurate documentation of audit findings and outcomes.
Manage assigned inventory and meet defined productivity, quality, and SLA targets.
Use available tools and applications to resolve assigned cases.
Follow process SOPs and stay updated with process changes.
Implement feedback from managers and quality teams to improve performance.




Maintain compliance with internal controls and data-security requirements.

Preferred Candidate Profile
Graduate in any discipline.
Maximum 4 years of experience in US Healthcare, BPO, Claims, or related processes.
US Healthcare experience is preferred, especially Payer/Provider Calling or Claims.
Freshers with excellent communication skills may also be considered.
Robust verbal and written communication skills.
Valuable analytical and problem-solving skills.
Ability to interpret data and make timely decisions.
Ability to work independently and handle multiple projects simultaneously.
Willingness to work in night/US shifts.
Good attention to detail and ability to follow defined processes and SOPs.

📌 Audit Support Assistant I Hyderabad
🏢 Cotiviti
📍 Hyderabad