Position Details
About this role
This role involves reviewing healthcare claims, analyzing data, and establishing the correct order of liability in coordination of benefits scenarios to ensure accurate recoveries for clients.
Key Responsibilities
- Review claims
- Analyze data
- Establish liability order
- Input recovery info
- Use Cotiviti tools
Technical Overview
Uses Cotiviti audit tools, Recovery Management System, RMS, and COB Tracker to review claims, analyze data, and validate COB order according to CMS and NAIC guidelines.
Ideal Candidate
The ideal candidate is a mid-level healthcare data specialist with experience in claims review, data analysis, and coordination of benefits, familiar with Cotiviti audit tools and regulatory guidelines. They are detail-oriented and analytical.
Must-Have Skills
Nice-to-Have Skills
Tools & Platforms
Required Skills
Hard Skills
Soft Skills
Industry & Role
Keywords for Your Resume
Deal Breakers
Lack of experience with claims review or COB, No familiarity with Cotiviti tools, Inability to work remotely
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