Are you passionate about accurate claims processing and auditing? Do you have deep knowledge of Durable Medical Equipment (DME) and HCPCS codes? If so, we’d love to have you on our team! EXL Health is looking for a Detail-Oriented, Claims-Savvy DME Auditor to join our fast-growing team. This is a fully remote opportunity – work from anywhere in the U.S. and help shape the future of healthcare auditing. EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com. EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers. EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.

Overview A Payment Accuracy, Coordination of Benefits (COB) Specialist 1 is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is covered by two or more health plans. This role is responsible for reviewing and analyzing the multi-client impact, complex member selection, and query or filter construction of data to identify instances of recoverable Coordination of Benefit claims for the benefit of Cotiviti and our clients. This individual works under limited supervision and is responsible for establishing the correct order of liability for our client’s members. Additionally, they input accurate claim recovery information in the proprietary Cotiviti software tools and assist with related inquiries throughout the claim recovery process. The position involves responsibility for moderate to more complex audit projects, ranging from low to midrange in scope. Responsibilities - This individual will work under limited supervision and will be monitored for efficiency in production and quality review of assigned work. - Demonstrates the ability to excel both independently and as a collaborative team player. - The scope of work involves complex member selections and multi-client impacts. - Capability and comfort in running and establishing queries and filters for construction and data reports. - Demonstrates proactive problem-solving skills and a keen ability to resolve data-related challenges efficiently, contributing to a solution-driven environment. - Possesses an in-depth knowledge of Centers for Medicare and Medicaid Services (CMS) and National Association of Insurance Commissioners (NAIC) guidelines, crucial for determining liability accurately. - Utilizes Cotiviti audit tools (Recovery Management System (RMS), COB Tracker, specific client systems) to complete member investigations. - Creates detail-oriented, accurate notes in Cotiviti audit tools and/or client tools throughout the member investigation. - Meets or exceeds standards of production and quality as identified by compliance and regulatory guidelines and set forth by the Team Lead and/or Manager when reviewing concept and claim identifications for the client. - Prepares and evaluates responses to client disputes both internally and externally within the Business Unit as needed. - Identifies opportunities for continuous improvement for efficiencies within reporting and streamlining research processes. - Demonstrates understanding of Cotiviti policies & procedures, and external regulatory requirements and performs duties in accordance with such regulatory requirements. - Demonstrates a deep understanding of the healthcare industry and a track record of delivering exceptional results. - Assures confidentiality and security of all data, adhering to all HIPAA (Health Insurance Portability and Accountability) laws and requirements. Demonstrates the skills, knowledge, and ability to ensure that our environment is a safe one, complying with industry standards. - Has ability to take responsibility for outcome, whether positive or negative and apply learning as applicable. - Integrates information from various sources and considers broader context. - Creates innovation to enhance the standard operating rhythm finding new pathways to complete work expectations. - Actively seeks information to understand rationale and provide exceptional results beyond basic standards. 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. Qualifications - High School Diploma - Required. - Bachelor’s degree (Preferred) and/or a minimum of at least two (2) years related experience in healthcare. - At least 1-2 years of Cotiviti experience is recommended for individuals seeking their next opportunity internally (e.g., employees in current COB Specialist or Payment Accuracy Specialist roles). - Healthcare industry experience, including knowledge of Coordination of Benefits (Required). - Computer proficiency including Microsoft Office (Word, Excel, Outlook). - Excellent verbal and written communication skills. - Strong interest in working with large data sets and various databases. - Ability to work well in an individual and team environment demonstrating self–motivation to deliver success. Mental Requirements: - Communicating with others to exchange information. - Assessing the accuracy, neatness, and thoroughness of the work assigned. Physical Requirements and Working Conditions: - Remaining in a stationary position, often standing or sitting for prolonged periods. - Repeating motions that may include the wrists, hands, and/or fingers. - Must be able to provide a dedicated, secure work area. - Must be able to provide high-speed internet access/connectivity and office setup and maintenance. - No adverse environmental conditions expected. Base compensation ranges from $22.60 to $26.00. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration. Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law. 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 family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page. Date of posting: 3/16/2026Applications are assessed on a rolling basis. We anticipate that the application window will close on 3/31/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected. #LI-Remote#LI-KB1#junior

Alternate Locations: Charlotte, NC (North Carolina); Greensboro, NC (North Carolina); Omaha, NE (Nebraska); Work from Home Work Arrangement: Remote : Work at home employee residing outside of a commutable distance to an office location. Relocation assistance: is not available for this opportunity. Requisition #: 75622 The Role at a Glance We are excited to bring on a highly motivated Integrated Absence Claims Specialist to staff our ever-growing claims organization. As an Integrated Absence Claims Specialist, you will manage a workload of Short-Term Disability claims and their associated leaves. You will be responsible for conducting initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations. You’ll complete a thorough training to develop new skills and give you the confidence you need to be successful in your new role. To learn more, please click the following link.{Day in the Life} What you'll be doing - Communicating with claimants, employers and various medical professionals through phone and e-mail to gather information regarding Short Term Disability Claims, Family Medical Leaves, and state benefits when applicable. - Collaborating with fellow case managers, nurse case managers and consulting physicians to make appropriate and timely claim determinations. - Reviewing complex medical records and effectively leveraging a variety of tools and resources to understand appropriate approval durations and future action planning - Completing accurate financial calculations consistent with company and state guidelines. What we’re looking for Must haves: December 2025 or May 2026 college graduates - Strong written and verbal communication skills - Excellent organization skills with the ability to multi-task - Passion for helping others Nice to haves: - Strong mathematical skills for payment calculations Application Deadline What’s it like to work here? At Lincoln Financial, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future. What’s in it for you: - Clearly defined career tracks and job levels, along with associated behaviors for each of Lincoln's core values and leadership attributes - Leadership development and virtual training opportunities - PTO/parental leave - Competitive 401K and employee benefits - Free financial counseling, health coaching and employee assistance program - Tuition assistance program - Work arrangements that work for you - Effective productivity/technology tools and training The pay range for this position is $28.82 an hour with anticipated pay for new hires between the minimum and midpoint of the range and could vary above and below the listed range as permitted by applicable law. Pay is based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln’s total rewards package for employees. In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual. Other rewards may include long-term incentives, sales incentives and Lincoln’s standard benefits package. About The Company Lincoln Financial (NYSE: LNC) helps people to confidently plan for their version of a successful future. We focus on identifying a clear path to financial security, with products including annuities, life insurance, group protection, and retirement plan services. With our 120-year track record of expertise and integrity, millions of customers trust our solutions and service to help put their goals in reach. Lincoln Financial Distributors, a broker-dealer, is the wholesale distribution organization of Lincoln Financial. Lincoln Financial is the marketing name for Lincoln Financial Corporation and its affiliates including The Lincoln National Life Insurance Company, Fort Wayne, IN, and Lincoln Life & Annuity Company of New York, Syracuse, NY. Lincoln Financial affiliates, their distributors, and their respective employees, representatives and/or insurance agents do not provide tax, accounting or legal advice. Lincoln is committed to creating an inclusive environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Follow us on Facebook, X, LinkedIn, Instagram, and YouTube. For the latest company news, visit our newsroom. Be Aware of Fraudulent Recruiting Activities If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters. Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln's fraud team at fraudhotline@lfg.com if you encounter a recruiter or see a job opportunity that seems suspicious. Additional Information This position may be subject to Lincoln’s Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities. Any unsolicited resumes or candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial are considered property of Lincoln Financial and are not subject to payment of agency fees. Lincoln Financial ("Lincoln" or "the Company") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex, age, national origin or disability. Opportunities throughout Lincoln are available to employees and applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558. This Employer Participates in E-Verify. See the E-Verify notices. Este Empleador Participa en E-Verify. Ver el E-Verify avisos.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary LOUISIANA RESIDENCY REQUIRED As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple perpetrators or intricate healthcare fraud schemes. - Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business - Researches and prepares cases for clinical and legal review - Documents all appropriate case activity in case tracking system - Facilitates feedback with providers related to clinical findings - Initiates proactive data mining to identify aberrant billing patterns - Makes referrals, both internal and external, in the required timeframe - Facilitates the recovery of company and customer money lost as a result of fraud matters - Provides on the job training to new Investigators and provides guidance for less experienced or skilled Investigators. - Assists Investigators in identifying resources and best course of action on investigations - Serves as back up to the Team Leader as necessary - Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters. - Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings - Gives presentations to internal and external customers regarding healthcare fraud matters and Aetna's approach to fighting fraud - Provides input regarding controls for monitoring fraud related issues within the business units Required Qualifications - LOUISIANA RESIDENCY REQUIRED - 3+ years investigative experience in the area of healthcare fraud and abuse matters. - Working knowledge of medical coding; CPT, HCPCS, ICD10 - Proficiency in Microsoft Office with advanced skills in Excel (must know how to do pivot tables). - Strong analytical and research skills. - Proficient in researching information and identifying information resources. - Strong verbal and written communication skills. - Ability to travel up to 10% (approx. 2-3x per year, depending on business needs) Preferred Qualifications - Previous Medicaid/Medicare investigatory experience - Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations for fraud and abuse. - Credentials such as certification from the Association of Certified Fraud Examiners (CFE), or an accreditation from the National Health Care Anti-Fraud Association (AHFI) - Knowledge of Aetna's policies and procedures. - Knowledge and understanding of complex clinical issues. - Competent with legal theories. - Strong communication and customer service skills. - Ability to effectively interact with different groups of people at different levels in any situation. Education: - Bachelor's degree or equivalent experience (3-5 years of working health care fraud, waste and abuse investigations). Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $91,800.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/27/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.