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Overview
We are a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in contributing to improving our retail clients' profitability and want to be part of a team that provides opportunities for career growth. If you want to make a difference and contribute to the service we provide our Retail clients, consider an opportunity to join our global retail recovery team as an Auditor II.

Job Summary

The critical function of a Contract Compliance Auditor II is to audit billings from our clients' suppliers in order to identify and quantify areas of financial non-compliance with contract terms. The work requires assessment of transaction data in relation to relevant contract provisions, and investigation of apparent areas of non-compliance with contract provisions. Verified instances of financial non-compliance often result in cost recoveries for our clients, as well as future savings from root cause identification and process improvement recommendations.
Responsibilities
  • Identify and Enter Claims:
    • Utilizes retail experience to perform audit procedures that include identifying and defining issues, developing criteria, reviewing 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: QA, auditing paid transactions, determining whether an over payment exists, identifying incorrect deductions, and data mining.
    • Communicate the results of your analysis clearly and concisely, in both written and verbal forms, to internal, supplier and client personnel.
    • Work independently, often balancing work activities between multiple audit engagements, ensuring each project continues to progress toward timely completion.
  • Effectively Utilize Audit Tools
    • Utilize and demonstrate advanced proficiency with audit tools, including MS Excel, IDEA, and others as appropriate. Perform data mining and analytics in order to verify and validate billing accuracy and compliance issues, and to support audit claims.
  • Meet or Exceed Standards/Guidelines for Productivity
    • In addition to regular and predictable attendance, maintain production goals by maintaining strong project management skills and moving a group of audits forward toward completion each day.
  • Meet or Exceed Standards/Guidelines for Quality
    • Demonstrate consistency in producing high quality work product. Implement self-check and review and work to eliminate calculation errors and inconsistencies. Participate in peer review of audit work to help the team maintain high quality standards.
  • Prepare Audit Reports and Communication with Clients and Suppliers
    • Help draft and issue audit reports that summarize completed audit activities and audit findings. Communicate and present audit results. Provide support of claims in both verbal and written form that is clear, concise and persuasive.
  • Review Contract and Client Transactions
    • Demonstrate aptitude in reviewing contract language in order to identify key, financial related provisions. Become familiar with supplier data support for invoicing and identify and capture relevant records that justify billable amounts.
  • Training and Development
    • Participate in team knowledge sharing and training activities. Exhibit personal initiative in learning new analytic tools and communication skills. Able to accept and provide constructive feedback in a collaborative team environment.
Qualifications
  • Bachelor's Degree in Accounting, Finance, Economics, and/or Business Administration or related field required
  • Master's in Accounting or Law degree preferred
  • Additional education and certifications including Master of Accountancy, CPA, CFE, CIA, CFF, CISA strongly preferred
  • Four to seven years' of hands-on experience auditing
  • Experience working in accounting, auditing and/or data mining positions, or equivalent combination of education and experience
  • Forensic accounting, advanced excel modeling (conditional formulas, lookups, pivot tables, arrays, and VBA programming), and data mining experience are also highly desirable
  • Must be a self-starter and able to work independently in a home office
  • Strong technical skills - Word, Excel, PowerPoint; IDEA, ACL a plus
  • Strong project management skills required
  • Excellent communication skills
Work Location / Travel
  • Position will work from home the majority of the time
    • Work location must be in the continental US
  • Will require travel up to 15%
  • Must have a dedicated and secure work area with high speed internet access / connectivity (cable, modem or DSL)...provided at your own cost. Other equipment will be provided by the company.
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Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.

We focus on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality. In addition, we support retail and life/legal industries with data management and recovery audit services.

Cotiviti applies deep data science and market expertise to help healthcare organizations in three critical areas:

·        Payment Accuracy: analyzing data flowing between payers and providers to ensure that claims are paid appropriately

·        Risk Adjustment: ensuring that health plans accurately capture and report how sick their members are so that plans are appropriately reimbursed for the healthcare services their members receive

·        Quality and Performance: evaluating healthcare cost, quality, and utilization at individual, provider, and population levels to identify the best opportunities for financial and clinical performance improvement