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Company Name : Cotiviti India
Location : Pune, Maharashtra
Position : Auditor
Job Description : Position Description
Title: Auditor I
Division: Global Retail
FLSA Classification: Exempt (Salaried)
Created Date: 06/18/2014
Position Summary
The Auditor position is responsible for auditing client data on behalf of Connolly’s clients and generating high quality recoverable claims for the benefit of Connolly and our clients. Responsible for conducting or assisting in the identification, validation and documentation of moderate to more complex audit projects. Primarily responsible for auditing efforts by executing more independent projects, low to mid range in scope assigned by the Audit Manager.
Key Responsibilities
Identify and Enter Claims
Utilizes retail experience to perform audit procedures that include identifying and defining issues, developing criteria, reviewing and analyzing evidence with the intent to audit standard medium – complex reports. Identify and validate over and under payments of claims. Work is moderate in scope and complexity. Knowledge is applied to resolve routine issues, as necessary. Scope may include: auditing paid transactions; determining whether an overpayment exists; identifying incorrect deductions; data mining. Enters the claim into Cotiviti system accurately and in accordance with standard procedures. Identify and discuss audit findings with audit team and document exceptions.
Effectively Utilize Audit Tools
Utilize and demonstrate with consistency, Cotiviti and client tools required to perform duties. Enter the claim into Cotiviti system accurately and in accordance with standard procedures. Upon proficiency with systems tools, may update current reports, develops and runs custom queries and validate accuracy of current reports used. Make determinations based on prior knowledge, experience of client contract terms with the likelihood of recovery acceptance.
Meet or Exceed Standards/Guidelines for Productivity
In addition to regular and predictable attendance, maintain production goals and quality standards set by the audit for the auditing concept. Audits against the standard expected level of quality and quantity (i.e. fees per hour, vendor/project volume completion, claims written).
Meet or Exceed Standards/Guidelines for Quality
Achieve the standard level of quality set by the audit for the auditing concept, for valid claim identification and documentation. Contributes in decisions on audit work completed after the various possibilities have
been considered.
Prepare Response to Client and Supplier Disputes
Respond to client/supplier disputes for claims written. Provide verification of claims validation and confirmation, in a concise written manner.
Review Client Transactions
Demonstrates aptitude in reviewing transaction types, client contracts/vendor agreements, and client data with limited supervision of how to identify potential over/under payments.
Recommend New Concepts and Processes
Leverages knowledge of client, contract terms and complex claim types. Works towards developing and implementing new ideas, approaches and/or technological improvements that will support and enhance audit production, communication and client satisfaction. Evaluates information and draws logical conclusions. Uses learned, tried and proven validation methods to test and produce a desired or intended result of the new concepts. May collaborate with Business Optimization in developing new reports.
Critical Success Factors
Lives Our Values
Understands and consistently demonstrates the spirit and behaviors associated with Cotiviti’s values.
Critical Thinker
Demonstrates adeptness in identifying errors and exceptions that result in valid claims. Has an eye for irregularities. Ability to analyze data, identify inconsistencies and formulate workable solutions. Demonstrates logical well-reasoned and timely decisions regarding his/her portfolio of work assignments.
Initiative Taker
Shows initiative and a willingness to engage in all areas of the audit. Reaches beyond current tasks to add value to audit team. Goes the extra step to solve problems instead of waiting for someone else to solve them. Successfully integrates and multi-tasks new assignments.
Technically Capable
Demonstrated competency with tools of the job including but not limited to computers, word processing & spreadsheet applications, web systems, Cotiviti and Client systems, and data file structures. Can efficiently download and format common file types. Demonstrates expertise and ability to master systems and applications including Decipher, Retrieiver and all systems needed for business segment.
Customer Centric
Treats customers/clients both internal and external as number one priority, is committed to continuous quality improvement, is courteous
and responsive to customer’s needs, meets or exceeds all customer commitments and treats customers honestly.
Deliver Results
Produces and documents well written claims, consistent with Cotiviti’s high level of integrity. Claims are well supported and documented and can be easily understood by client and provider/supplier community.
Consistently meets or exceeds goals at expected levels of quality and productivity. Demonstrates willingness and readiness to take on more responsibility in support of the audit.
Time Management
Ensures timely completion of audit reports. Exhibit’s an understanding of audit planning activities and uses a structured and dependable approach to accomplishing assigned work.
Regulatory/Compliance
Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements. Assures confidentiality and security of all data. Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards.
Continuous Improvement
Identify opportunities to improve the efficiency of standard reporting, streamline the research process and strive to increase the fees per hour. Frequently offers constructive, unsolicited suggestions and recommendations for process improvement and efficiencies. Actively conceptualizes new reports and/or root cause solutions.
Education
Degree Program of Study Required/Preferred
Bachelors Finance Required
Educational Requirements
Any Bachelor’s Degree in Finance, Accounting and/or Business Administration. Experience in accounting, retail environment (merchandising, buying, or audit ) preferred.
Certifications & Licensures
Certifications/Licensures Required
B1 and above level Certification in French / Spanish / German from any Recognized Institute or University.
Sills and Experience
Experience Requirements
Strong working knowledge and understanding of retail industries preferred.
2-4+ years of hands-on experience auditing.
Proven analytic experience using Microsoft Excel, Access database query capabilities and ability to assess data at various levels of detail.
Investigative skills, including the ability to evaluate facts and evidences to draw conclusions, even if information is limited as well as explain problems or situations using a systematic framework.
Strong communication skills, including ability to build relationships and articulate thoughts clearly and effectively.
Ability to succeed in a frequently changing and unstructured environment and deal with ambiguity.
Team player that works collaboratively with various team members to accomplish integrated solutions.
Disclaimer
This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.
Employee Statement of Understanding
I have read and understand the job description for my position. I am able to perform all of the essential functions of this position.
I agree to comply with the corporate compliance policy and all laws, rules, regulations and standards of conduct relating to my position. As an employee, I understand my duty to report any suspected violations of the law or the standards of conduct to my immediate supervisor.
As an employee, I will strive to uphold the mission and vision of the organization. All employees are required to adhere to the values in all their interactions with patients, customers, and fellow employees.
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