Payment Accuracy COB Specialist

Cotiviti•Remote,

2d•$21 - $24•Remote

About The Position

The Payment Accuracy, Coordination of Benefits (COB) Specialist is part of the Coordination of Benefits Business Unit. The role reviews and analyzes claims, member, and group data to identify recoverable claims and establish the correct order of liability for clients’ members. Under direct supervision, the specialist enters accurate claim recovery information into Cotiviti’s proprietary software and assists with related inquiries throughout the recovery process. The specialist uses Cotiviti and client systems to investigate members, document findings, evaluate disputes, and meet production and quality standards. The role requires applying applicable CMS, NAIC, HIPAA, and other regulatory requirements while maintaining data confidentiality and security. The position may involve completing assigned projects and other duties as needed, and duties must be performed with or without reasonable accommodation. The role requires a dedicated, secure work area, high-speed internet access, and an office setup and maintenance. The base compensation range is $20.50 to $23.75 per hour, with eligibility for discretionary bonus consideration. Nonexempt employees are eligible for overtime pay for hours worked over 40 in a week, or as required by applicable state law. The posting date is 10/27/2026, and the anticipated application window closing date is 11/6/2026, subject to change.

Requirements

High school diploma required.
Bachelor’s degree preferred and/or at least one year of related healthcare experience.
Computer proficiency, including Microsoft Word, Excel, and Outlook.
Excellent verbal and written communication skills.
Ability to work with large datasets and diverse databases.
Ability to work independently and in a team, with self-motivation and determination.
Ability to analyze large volumes of data and identify trends, discrepancies, and anomalies, with exceptional attention to detail.
Strong critical-thinking skills and ability to assess complex situations, identify issues, and propose practical solutions.
Ability to make informed decisions based on data, regulations, and auditing standards.
Understanding of auditing standards, regulations, and industry best practices and ability to apply them consistently.
Ability to recognize when further investigation is needed and probe records or processes to uncover inconsistencies or irregularities.
Ability to provide a dedicated, secure work area and high-speed internet access, with office setup and maintenance.
Ability to remain stationary, often standing or sitting for prolonged periods, and perform repetitive motions involving the wrists, hands, and/or fingers.
Ability to perform duties with or without reasonable accommodation.

Nice To Haves

Bachelor’s degree.
Healthcare industry experience, including knowledge of Coordination of Benefits.
At least one year of Cotiviti experience is recommended for internal candidates seeking their next opportunity, such as Retrieval Agent or Audit Support experience.

Responsibilities

Review and analyze claims, member, and group data to identify recoverable claims.
Establish the correct order of liability for clients’ members.
Enter accurate claim recovery information into Cotiviti’s proprietary software tools and assist with related inquiries during the claim recovery process.
Work under direct supervision and meet production efficiency and quality review expectations.
Develop and maintain knowledge of CMS and NAIC guidelines to determine liability order accurately.
Use the Recovery Management System (RMS), COB Tracker, and client-specific systems to conduct member investigations.
Create accurate, detailed notes in Cotiviti or client audit tools throughout investigations.
Meet or exceed production and quality standards established by compliance and regulatory guidelines and by the Team Lead and/or Manager.
Prepare and evaluate responses to client disputes, internally and externally within the Business Unit, as needed.
Classify errors and overpayments and solve problems for healthcare clients.
Identify opportunities to improve reporting efficiency and streamline research processes.
Perform duties in accordance with Cotiviti policies and procedures and external regulatory requirements.
Maintain confidentiality and data security in compliance with HIPAA requirements.
Take responsibility for outcomes and apply lessons learned; integrate information from different sources, consider broader context, seek information, and test promising ideas.
Complete responsibilities in the annual Performance Plan, special projects, and other assigned duties.