Client Service Associate

Overview

The Client Service Associate's (CSA) role is to ensure adequate support for the client-facing team on coding and policy-related activities. The CSA must be familiar with the day-to-day activities of the Client Policy Manager (CPM), Client Service Manager (CSM), and client-facing Medical Directors.

Responsibilities

• Creates and captures decisions when appropriate CDM Presentations (New Policy Presentations, Periodic Updates, and Prior Approvals)
• Creates and closes Project Requests as defined by CPM/CSM
• Conducts initial CCI deviations table review (post-implementation)
• Assist CPM in research and analysis to produce comparison reports for Outpatient Hospital, Professional, and DME Max Unit Tables to CPM as requested by the client team
• Reviews, analyzes, and responds to Research Request(s) by defined desired completion date or communicates when desired completion date needs to be adjusted due to complexity
• Supports Client Policy Manager through the various aspect of the Periodic Update, Prior Approval, and New Policy Processes
• Communicates effectively with various members of the Client Team(s)
• Performs multi-faceted analytics in data and report analysis
• Running of Release Validation Reports and completing the review of the data (twice per release cycle)
• Running Max Units Reports, completing the review of the data, and making recommendations for changes/updates
• Review of Pre & Post Release Testing Reports
• Generate, modify and format BO/Webi Reports for adhoc purposes and provides analysis.
• Ability to validate the Release Validation Report (RVR) report post-release.
• Manual JIRA creation and client response
• Client Inquiry Log entries and reporting
• Ability to research and examine client questions to draft an accurate response
• Actively participate in team meetings and other relevant meetings

Other Related Responsibilities

• Other duties as assigned

Qualifications

• Effective problem-solving skills
• Prior experience in developing medical payment policy edits
• Professional with the ability to properly handle confidential information
• Ability to work well independently and in a team environment
• Ability to handle multiple tasks, prioritize and meet deadlines
• Excellent written and verbal communication skills
• Attention to detail and accuracy
• Organizational skills
• Works with a sense of urgency
• Ability to follow defined policies and procedures
• Strong analytical and problem-solving ability
• Strong interpersonal skills
• US Healthcare industry and claims analysis experience
• Desire and capacity to learn new concepts and software
• Ability to work within a matrix organization
• Exhibits behaviors consistent with Cotiviti Values
  • Customer Driven
  • Accountable
  • Open
  • Collaborative

MINIMUM QUALIFICATIONS:

• High School Diploma or GED required, Bachelor's degree preferred
• Prefer experience with Medical Coding and Terminology and/or clinical exposure, (CPC, CCS, or RHIA certification)
• Excellent analytical skills with the ability to troubleshoot problems and find root causes
• Proficiency required in Business Objects (or similar business intelligence software), and relational databases
• Advanced knowledge of Excel (pivot tables, complex formulas, VLOOKUPs, statistical functions)
• Ability to learn and quickly absorb new material
• Ability to adapt to changing situations with ease
• Team player with a strong desire to assist and share knowledge
• Flexible schedule to work evenings and weekends, as needed

JOB DEMANDS:

• Must be able to sit and use a computer keyboard for extended periods of time
• Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones
• This is an at-home-based position and you must have a work location within the continental US
• Interviewing & training will be done remotely
• This position requires that you provide a high-speed internet connection and a work environment free from distractions

Base compensation ranges from $20.00 Hr. to $24.00 Hr. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

 

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid