FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare payment accuracy audits, including the development and evaluation of audit concepts, while effectively mentoring audit staff and ensuring high-quality outcomes. Proficient in SQL and Microsoft tools to enhance audit processes and productivity metrics.
Highest-signal resume keywords
Healthcare Payment Accuracy AuditsSQL ProficiencyMicrosoft ExcelAudit Staff MentoringHealthcare Billing Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Audit Concept DevelopmentComplex Audit Project ExecutionAudit Quality ControlClaims ValidationData Analysis
Soft Skills
Excellent Communication SkillsTeam CollaborationIndependent Work AbilityMentoring Skills
Tools & Technologies
Microsoft AccessProprietary SoftwareSystem Databases
Industry Keywords
Healthcare BillingMedical ClaimsReimbursementAnalyticsIndustry-Based Standards
Tech Stack
Tools & technologiesSQL
About the role
Key responsibilities & impact- Develop new and existing healthcare payment accuracy audit concepts
- Gain client acceptance and expand approved audit concepts based on customer requirements
- Train audit staff to execute basic, intermediate, and complex audit projects
- Conduct and document complex audit projects independently
- Evaluate audit concept effectiveness, recoveries, collectability, and client acceptance
- Collaborate with Business Optimization and audit teams to develop new reports, tools, and processes
- Review auditor claims before and after client submission for quality control
- Monitor audit quality and productivity metrics, including hit rate, claims written, and identification per hour
- Prepare responses to client disputes and oversee claim validation
- Review provider contracts and research medical policies and state and federal statutes
- Validate new claim types and audit concepts
- Mentor, assess, and support the progression and staffing of audit team members
- Ensure proper use of proprietary software, reports, and IT resources
Requirements
What you’ll need- Bachelor's degree preferred
- Three (3) years of Cotiviti direct audit experience OR four (4) years of related experience in healthcare billing, healthcare/medical claims, reimbursement, or analytics
- Experience using SQL required
- Computer proficiency in Microsoft Excel, Access, and system databases required
- Ability to mentor staff and enhance auditor quality and productivity
- Prior healthcare billing and/or claims experience desired
- Working knowledge of applicable industry-based standards
- Excellent verbal and written communication skills
- Ability to work well independently and in a team environment
- Ability to provide a dedicated, secure work area
- Ability to provide high-speed internet access/connectivity and office setup and maintenance
Benefits
Comp & perks- Discretionary bonus consideration
- Medical insurance
- Dental insurance
- Vision insurance
- Disability insurance
- Life insurance coverage
- 401(k) savings plan
- 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
- Secure dedicated work area and high-speed internet/office setup required for remote work