Auditor

Overview:
**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**

**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 complet