Senior Auditor (Retail) - COTIVITI, INC.
SOUTH JORDAN, UT
About the Job
Senior Auditor (Retail)
Job Locations
US-Remote
ID
2024-12445
Category
Audit - Retail
Position Type
Full-Time
Overview
The Senior Auditor position is responsible for auditing client data on behalf of Cotiviti's clients and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Responsible for conducting or assisting in the identification, validation, and documentation of moderate to more complex audit projects. Primarily responsible for mid to high auditing efforts by executing more independent projects assigned by the Audit Manager.
Responsibilities
Utilizes retail experience to perform audit procedures that include identifying and defining issues, developing criteria, and reviewing and analyzing evidence with the intent to audit standard medium-complex reports.
* Identify and validate over and under-payments of claims.
* Work is advanced in scope and complexity. Scope may include: quality assurance, auditing paid transactions, determining whether an overpayment exists, identifying incorrect deductions, and data mining.
* Enter claims into Cotiviti's system accurately in accordance with standard procedures.
* Advanced identification of audit findings; reviews audit findings with the audit team and documents exceptions as part of knowledge sharing for results.
* Utilize, with advanced proficiency, Cotiviti and client tools required to perform duties. Works with IT to increase the efficiency of tools and reporting.
* Update current reports, develop and run custom queries, and validate the accuracy of current reports used.
* Make determinations based on prior knowledge, best practices, and experience of client contract terms with the likelihood of recovery acceptance.
* In addition to regular and predictable attendance, maintain production goals and quality standards set by the audit for the auditing concept.
* Highly proficient subject matter expert for client disputes for claims written. Provide verification of claims validation and confirmation, in a concise written manner.
* Demonstrate a high level of expertise in reviewing transaction types, client contracts and vendor agreements, and client data with limited supervision of how to identify potential over/underpayments.
* Participate in the onboarding of employees new to the audit. Be a skilled resource regarding how to review and explain audit tools, client-specific terminology, and people resources including colleagues, clients, and other stakeholders.
* Use proven methodologies to research and substantiate claims outside of the concept where additional recoveries may be available.
* Enlists others internally or externally to suggest, validate, develop, and analyze high-quality, high-value concepts and/or process improvement, tools, etc. Strong driver and voice in the development of audit concepts.
* Based on experience and in-depth knowledge of clients, contract terms, and complex claim types, suggest and/or develop and implement new ideas, approaches, and/or technological improvements that will support and enhance audit production, communication, and client satisfaction.
* Evaluate the information and draw logical conclusions. Use validation methods to test and produce a desired or intended result of the new concepts. Collaborates with Business Optimization in developing new reports.
* Complete all responsibilities as outlined in the annual performance review and/or goal setting. Required.
* Complete all special projects and other duties as assigned. Required.
* Must be able to perform duties with or without reasonable accommodation. Required.
This job description is intended to describe the general nature and level of work being performed and is not to be construed... For full info follow a
pplication link.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
Job Locations
US-Remote
ID
2024-12445
Category
Audit - Retail
Position Type
Full-Time
Overview
The Senior Auditor position is responsible for auditing client data on behalf of Cotiviti's clients and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Responsible for conducting or assisting in the identification, validation, and documentation of moderate to more complex audit projects. Primarily responsible for mid to high auditing efforts by executing more independent projects assigned by the Audit Manager.
Responsibilities
Utilizes retail experience to perform audit procedures that include identifying and defining issues, developing criteria, and reviewing and analyzing evidence with the intent to audit standard medium-complex reports.
* Identify and validate over and under-payments of claims.
* Work is advanced in scope and complexity. Scope may include: quality assurance, auditing paid transactions, determining whether an overpayment exists, identifying incorrect deductions, and data mining.
* Enter claims into Cotiviti's system accurately in accordance with standard procedures.
* Advanced identification of audit findings; reviews audit findings with the audit team and documents exceptions as part of knowledge sharing for results.
* Utilize, with advanced proficiency, Cotiviti and client tools required to perform duties. Works with IT to increase the efficiency of tools and reporting.
* Update current reports, develop and run custom queries, and validate the accuracy of current reports used.
* Make determinations based on prior knowledge, best practices, and experience of client contract terms with the likelihood of recovery acceptance.
* In addition to regular and predictable attendance, maintain production goals and quality standards set by the audit for the auditing concept.
* Highly proficient subject matter expert for client disputes for claims written. Provide verification of claims validation and confirmation, in a concise written manner.
* Demonstrate a high level of expertise in reviewing transaction types, client contracts and vendor agreements, and client data with limited supervision of how to identify potential over/underpayments.
* Participate in the onboarding of employees new to the audit. Be a skilled resource regarding how to review and explain audit tools, client-specific terminology, and people resources including colleagues, clients, and other stakeholders.
* Use proven methodologies to research and substantiate claims outside of the concept where additional recoveries may be available.
* Enlists others internally or externally to suggest, validate, develop, and analyze high-quality, high-value concepts and/or process improvement, tools, etc. Strong driver and voice in the development of audit concepts.
* Based on experience and in-depth knowledge of clients, contract terms, and complex claim types, suggest and/or develop and implement new ideas, approaches, and/or technological improvements that will support and enhance audit production, communication, and client satisfaction.
* Evaluate the information and draw logical conclusions. Use validation methods to test and produce a desired or intended result of the new concepts. Collaborates with Business Optimization in developing new reports.
* Complete all responsibilities as outlined in the annual performance review and/or goal setting. Required.
* Complete all special projects and other duties as assigned. Required.
* Must be able to perform duties with or without reasonable accommodation. Required.
This job description is intended to describe the general nature and level of work being performed and is not to be construed... For full info follow a
pplication link.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
Source : COTIVITI, INC.