Auditor (Retail) - Bilingual English / Spanish

at  Cotiviti

Overview:
The Auditor Retail role is an entry level position responsible for auditing client data and/or documentation on behalf of Cotiviti’s clients and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Under direct supervision, identifies and inputs recovery claims, voids, or other over-underpayment types. Documents relevant facts, information, and conclusions drawn to support the work performed so other reviewers may validate claim. Communicates audit recommendations to supervisory auditor for evaluation, verification, and continuous learning.
This position requires candidates to be fully bilingual with a high level of English proficiency (written & spoken). This role will report to a US based manager who is not bilingual.

Responsibilities:

• Under direct supervision, audit standard reports, smaller/lower profile project-based routines and identify over and under payments of claims.
• Scope may include auditing paid claims; determining whether an overpayment exists; duplicate payments; identifying incorrect contract or contract rates; data mining.
• Enter the claim into Cotiviti system accurately and in accordance with standard procedures.
• Work on less complex/medium standard audit reports with support and may include the review and documentation of claim potentials identified by Auditors and Sr. Auditors.
• Utilize with increasing proficiency, proprietary reports, tools, and systems required to perform duties.
• With moderate guidance and direction, timely executes assigned standard reports and updates.
• Working proficiency with all systems and applications including Decipher and client tools.
• Maintain production goals and quality standards set by the audit for the auditing concept.
• Works to meet the expected level of quality and quantity (i.e., fees per hour, vendor/project volume completion, claims written) determined for the audit.
• Respond to client/vendor disputes or internal QA for claims written.
• Provide verification of claims validation, in concise written and oral manner.
• Build a personal proficiency around transaction types, client contracts/vendor agreements, and client data with understanding of how to identify potential over/under payments.
• 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.

Qualifications:

• Bachelor’s Degree in Finance, Accounting and/or Business Administration, or at least four years of equivalent experience required
• Computer proficiency in Microsoft Office (Word, Excel, Outlook); Access preferred
• Strong interest in working with large data sets and various databases
• Retail industry experience desired
• Excellent verbal and written communication skills
• Self-motivated and driven to succeed
• Must have strong English speaking and writing skills

• Under direct supervision, audit standard reports, smaller/lower profile project-based routines and identify over and under payments of claims.
• Scope may include auditing paid claims; determining whether an overpayment exists; duplicate payments; identifying incorrect contract or contract rates; data mining.
• Enter the claim into Cotiviti system accurately and in accordance with standard procedures.
• Work on less complex/medium standard audit reports with support and may include the review and documentation of claim potentials identified by Auditors and Sr. Auditors.
• Utilize with increasing proficiency, proprietary reports, tools, and systems required to perform duties.
• With moderate guidance and direction, timely executes assigned standard reports and updates.
• Working proficiency with all systems and applications including Decipher and client tools.
• Maintain production goals and quality standards set by the audit for the auditing concept.
• Works to meet the expected level of quality and quantity (i.e., fees per hour, vendor/project volume completion, claims written) determined for the audit.
• Respond to client/vendor disputes or internal QA for claims written.
• Provide verification of claims validation, in concise written and oral manner.
• Build a personal proficiency around transaction types, client contracts/vendor agreements, and client data with understanding of how to identify potential over/under payments.
• 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