Manager, Payment Accuracy (COB)

Cotiviti

2d • Remote

About The Position

The Coordination of Benefits (COB) Manager works within the COB Business Unit, specializing in managing cases where individuals have multiple health insurance plans. In this role, you'll lead a team dedicated to achieving strategic goals that benefit our team, Cotiviti, and our client relationships. This role is responsible for leading a team of individuals to meet established goals and deliver financial targets as defined by audit expectations and assists the leadership team with developing the team’s strategic plan for future growth. Additionally, people management, interviewing, forecast and budgeting, and retention efforts as well as fostering a culture aligned with Cotiviti’s values of Collaboration, Openness, Accountability, and Customer – Driven are key areas where success will be identified.

Requirements

• High School Diploma - Required
• Healthcare industry experience, including knowledge of Coordination of Benefits. (Required).
• Advanced digital proficiency across Microsoft Office suite, demonstrating technical adaptability and data-driven decision-making capabilities.
• Excellent verbal and written communication skills.
• Strong interest in working with large data sets and various databases.
• Expresses and demonstrates self–motivation, accountability, and drives results.
• Passionate to lead a team, creating and maintaining a safe culture for all team members.
• Ability to navigate various personalities and excel at conflict resolution.
• Understands and embodies Cotiviti Core Values, Strategic Pillars, and Operations Disciplines to achieve successful performance in completing assigned responsibilities and interactions with the Organization both internally and externally.
• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Nice To Haves

• Bachelor’s degree (Preferred) and/or a minimum of at least 6 - 8 years related experience in healthcare.
• At least 4 - 5 years Cotiviti experience is recommended for individuals seeking their next opportunity internally. (Example: Team Lead roles and/or Managers within Enterprise).
• Prior exposure mentoring, leading a team, and responsibility for team outcomes in addition to individual outcomes (Preferred).

Responsibilities

• Leads a People Leader + team and/or individual contributors. This individual operates autonomously with independent judgment and has the ability to review and approve operational functions within the team.
• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best-in-class practices to support and drive high levels of internal and external customer satisfaction.
• Performs time management reviews for Payroll processing utilizing a time management system, ensuring employees are working an approved schedule by leadership, applying necessary time off codes, and adhering to Company Policies for timely approval.
• Performs performance management of employees to ensure employees are meeting and achieving work expectations and deliverables.
• Performs goal planning and distribution, 30/60/90-day onboarding reviews for new hires and/or individuals newly promoted in a role, performance review check–ins and annual performance reviews.
• Participates in assigned leadership training as assigned as well as enhances individual leadership skills by participating in LinkedIn Learning self–directed sessions.
• Creates succession plans and identifies key talent.
• Creates retention strategies to implement future success by reviewing feedback, Company surveys and/or other available platforms.
• Creates comprehensive standard operating procedures and innovative training resources that empower teams to excel and set new benchmarks for operational efficiency.
• Provides mentorship and guidance to team members through coaching, training and/or 1:1s.
• Completes bi – weekly or monthly 1:1 meetings/team meetings with team members to review individual and team performance.
• Participates in functional leadership presentations for townhalls, clients and/or other projects as assigned, internally and externally.
• Serve as a subject matter expert, with comprehensive knowledge of work processes and client needs across all levels of the organization.
• Forecasts projected productivity to review financial targets with Senior Leadership and identify solutions should projects demonstrate a deviance to the target.
• Has subject matter expertise in understanding of Centers for Medicare and Medicaid Services (CMS) and National Association of Insurance Commissioners (NAIC) guidelines to establish correct order of liability.
• Has full understanding of client parameters and can communicate these effectively to team members and others throughout the organization.
• Has advanced level of knowledge of Cotiviti audit tools (Recovery Management System (RMS), COB Tracker, specific client systems) and can articulate to team members when to utilize various systems.
• Monitors production of team members against established goals; assists with formulating plan if goals are not being consistently met.
• Demonstrates understanding of payment integrity industry and how COB functions in this industry.
• Regularly reviews and holds team accountable in terms of quality as identified by compliance and regulatory guidelines and set forth by the client and Cotiviti.
• Identifies and emphasizes critical priorities to ensure time and energy is aligned with organization and business unit goals.
• Has ability to see beyond short term issues to understand the bigger picture and can anticipate unexpected effects.
• Identifies opportunities for continuous improvement for efficiencies within reporting and streamline research processes.
• Has an expert level understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements.
• Has a highly advanced understanding of the healthcare industry, as well as proven track record of delivering results.
• Performs complex operational analysis of audit performance and communicates results to stakeholders.
• Identifies areas for growth opportunity and executes plan to capture opportunity.
• Highly involved in development and review of new and existing concepts, ensuring achievement of goals.
• Direct responsibility for overall quality of work produced within audit – holds audit team accountable for execution of quality work as defined by audit parameters.
• Executes and adjusts to budget demands of audit and drives the profitability of the audit engagement
• Assures confidentiality and security of all data, adhering to all HIPAA (Health Insurance Portability and Accountability) laws and requirements. Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards.
• Has ability to take responsibility for outcome, whether positive or negative and apply learning as applicable.
• Integrates information from various sources and considers broader context.
• Creates innovation to enhance the standard operating rhythm finding new pathways to complete work expectations.
• Actively seeks information to understand rationale and provide exceptional results beyond basic standards.
• Complete all responsibilities as outlined on annual Performance Plan.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

Benefits

• 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 specific level and length of service with Cotiviti.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: High school or GED