Payment Accuracy COB Specialist

Cotiviti

. Review and analyze claims, member, and group data to identify recoverable claims .

Posted 10/27/2026full-timeRemote • United StatesJunior💰 $21 - $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing claims and member data while adhering to CMS and NAIC guidelines. Proficient in utilizing Cotiviti software tools and Recovery Management Systems to enhance claim recovery processes and ensure compliance with healthcare regulations.

Highest-signal resume keywords

Cotiviti ExperienceHealthcare Industry KnowledgeData Analysis SkillsAuditing Standards UnderstandingCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisData RecoveryData AnalysisRegulatory ComplianceError ClassificationTrend IdentificationAuditing StandardsHealthcare Claims ProcessingCoordination Of BenefitsPerformance Evaluation

Soft Skills

Critical ThinkingProblem-SolvingVerbal CommunicationWritten CommunicationDecision-Making

Tools & Technologies

Cotiviti SoftwareRecovery Management SystemCOB TrackerMicrosoft OfficeClient Audit Tools

Industry Keywords

HealthcareClaims RecoveryCompliance GuidelinesHIPAA RequirementsData Discrepancies

About the role

Key responsibilities & impact

Review and analyze claims, member, and group data to identify recoverable claims
Establish the correct order of liability for clients’ members
Input accurate claim recovery information into Cotiviti software tools
Assist with inquiries throughout the claim recovery process
Work under direct supervision and meet production and quality standards
Apply CMS and NAIC guidelines to determine liability order
Use Recovery Management System (RMS), COB Tracker, and client-specific systems for member investigations
Create accurate notes in Cotiviti and/or client audit tools
Review concept and claim identifications for clients in accordance with compliance and regulatory guidelines
Prepare and evaluate responses to internal and external client disputes
Classify errors and overpayments for healthcare clients
Identify opportunities to improve reporting efficiency and streamline research processes
Follow Cotiviti policies, procedures, HIPAA requirements, and external regulations
Complete annual Performance Plan responsibilities, special projects, and other assigned duties

Requirements

What you’ll need

High School Diploma - Required
Bachelor’s degree (Preferred) and/or a minimum of one (1) year of related experience in healthcare
At least 1-year Cotiviti experience is recommended for individuals seeking their next opportunity internally
Healthcare industry experience, including knowledge of Coordination of Benefits (Preferred)
Computer proficiency including Microsoft Office (Word, Excel, Outlook)
Excellent verbal and written communication skills
Ability to work with large datasets and diverse databases
Ability to provide a dedicated, secure work area
Ability to provide high-speed internet access/connectivity and office setup and maintenance
Ability to analyze large volumes of data and identify trends, discrepancies, and anomalies
Strong critical thinking and practical problem-solving skills
Ability to make informed decisions based on data, regulations, and auditing standards
Strong understanding of auditing standards, regulations, and industry best practices
Ability to recognize issues requiring further investigation
Must be able to perform duties with or without reasonable accommodation

Benefits

Comp & perks

Discretionary bonus consideration
Overtime pay eligibility for hours worked over 40 hours per week, or as required by applicable state law
Medical, dental, vision, disability, and life insurance coverage
401(k) savings plans
Paid family leave
9 paid holidays per year
17–27 days of Paid Time Off (PTO) per year, depending on level and length of service