Payment Accuracy COB Specialist

Overview A Payment Accuracy, Coordination of Benefits (COB) Specialist, is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is covered by two or more health plans. Our specialists are passionate about what they do and are experts at reviewing, discovering, and validating substantial amounts of data and delivering results and insights for our clients. A Payment Accuracy, COB Specialist, is responsible for reviewing and analyzing claims, member, and group data to identify instances of recoverable claims for the benefit of Cotiviti and our clients. Under direct supervision, this individual will be responsible for establishing the correct order of liability for our clients’ members. This individual will also be responsible for inputting accurate claim recovery information in the proprietary Cotiviti software tools, as well as assisting with related inquiries throughout the claim recovery process. Responsibilities This individual will work under direct supervision and will be monitored for efficiency in production and quality review of assigned work. Demonstrates a strong ability to proactively develop and uphold a solid grasp of Centers for Medicare and Medicaid Services (CMS) and National Association of Insurance Commissioners (NAIC) guidelines to accurately determine liability order. Leverages cutting-edge Cotiviti audit tools such as the Recovery Management System (RMS), COB Tracker, and cl