Operations Administrator Job Locations

US-Remote ID

2024-12728

Category Clinical Operations  

Position Type Full-Time Overview

Operations Administrator (OA) is responsible for daily support of functions across the CCV BU teams, including audit and client support to ensure that all processes are adhered to, metrics are met or exceeded, and documentation is created and maintained with high attention to quality and detail.  The OA may flex to support various teams throughout the day, utilizing a variety of Cotiviti proprietary tools to complete tasks.  OA may also access client data systems directly to validate claim information.  

Responsibilities

Reporting / Metrics: The OA maintains focus on specific tasks to ensure client SLAs are met. Provides CCV management team with analytics and ad hoc reporting. * Provides direct support to the CCV Business Unit: Utilizing data provided by the team, the OA formats and prepares specific reports. With proficiency, the OA research's client inquiries and follows through to resolution of those inquiries. Client inquiries may include but are not limited to requests for verification of regulatory notices to Providers and Federal facilities, previous letter mailings, and requests for duplicate letters. * Coordinates Internal Processes: Communicates across business lines in a highly matrixed organization relative to open inventory report management. Ensures accuracy of necessary documentation required for the audit team. * Enters and maintains Service Ticket requests and document management: Based upon CCV Management feedback, the OA will research issues related to proposed tickets requests. Submits tickets requests as appropriate. Resolves outstanding documentation management issues and follows-up as necessary to ensure completion. * Internal Communication: Schedules and coordinates meetings with the CCV Business Unit team members of all levels to address issues and ensure clear communication within the teams. * Miscellaneous: Other duties as assigned or as business needs may require. * Complete all responsibilities as outlined on annual Performance Plan. Required * Complete all special projects and other duties as assigned. Required * Must be able to perform duties with or without reasonable accommodation. Required

Qualifications

• High School Diploma or GED required.  Some college preferred.
• Minimum one year directly related to healthcare.
• Previous health care claim review experience preferred.
• Intermediate Excel, and Microsoft Office Suite skills are required.
• Strict attention to detail in actions and documentation.
• Consistent and effective critical thinking skills required.
• Must be driven and a self-starter.
• Must be flexible and willing to adapt to an ever-changing environment.
• Ability to multitask, shift across clients as needed; Highly skilled at handling multiple tasks simultaneously, prioritizing and meeting deadlines.
• Works with a sense of urgency.
• Strong organizational skills (including a commitment to thorough documentation of results).
• Strong written and verbal communication skills in person as well as with remote and international resources.
• Professional demeanor with ability to use appropriate language, tone, style and structure in oral and written communications.
• Positive and helpful demeanor in interactions with all internal/external stakeholders.
• Active listening skills.
• Ability to maintain strict confidentiality in all communications involving sensitive information and algorithms.
• Ability to work well independently and in a team environment.
• Exhibits behaviors consistent with Cotiviti Values. Job Dema nds
• Remaining in a stationary position, often standing,... For full info follow application link.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities