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Cotiviti · 4 days ago
Content Analyst II
United States
Full-time
Remote
Mid, Senior Level
$68K/yr - $95K/yr
5+ years exp
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Responsibilities
Provide coding and industry expertise to help create and maintain clinical coding edits.
Responsible for writing business logic for new rules and enhancements by translating industry references into Cotiviti policy.
Reviews and identifies changes to medical policies in order to maintain an accurate and current medical policy library.
Work with the client teams to provide coding and clinical expertise for customer and provider inquiries, questions, challenges, or appeals to clinical rules.
Assumes full ownership and accountability for assigned medical policies.
Performs multi-faceted analytics for data and report analysis with minimal direction.
Mentor and train new staff.
Performs QA of policy reviews, logic revisions, and research requests performed by others to ensure accuracy.
Maintains current knowledge-base of industry and Cotiviti content, best practices, applications, procedures, and policies.
Qualification
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Required
One of the following degrees is required: Active professional license as a Registered Nurse (BSN preferred), Pharmacist (BSPharm or PharmD), Bachelor’s degree (healthcare-related field preferred), Offshore Medical Degrees (MBBS or higher)
Professional certification (RHIA, RHIT, CPC, CPC-H, CPC-P, or CCS-P) preferred or willing to pass certification exam within one year of employment.
Minimum of 5 years of experience in a clinical setting as a nurse, pharmacist, or physician OR minimum of 6 years of clinical coding experience, preferably in a payer setting.
Minimum of 3 years of experience in internet-based research as it relates to codes (CPT, HCPCS, ICD, or NDC)
Familiarity with claims payment and reimbursement methodologies as well as medical policy rules and edits.
Ability to analyze complex data and synthesize it for customer and internal consumption.
Ability to work well both independently and collaboratively, in a fast-paced and demanding environment.
Effective at managing timelines and multiple projects with high accuracy and attention to detail.
Strong analytical, critical thinking, and problem-solving skills.
Proficiency in Microsoft Office suite.
Excellent interpersonal, verbal, and written communication skills.
Benefits
Medical insurance
Dental insurance
Vision insurance
Disability insurance
Life insurance
401(K) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year
Company
Cotiviti
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States.
5,001-10,000 employees
H1B Sponsorship
Cotiviti has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Trends of Total Sponsorships
2023 (77)
2022 (91)
2021 (84)
2020 (68)
Funding
Current Stage
Late StageLeadership Team
Adam Gilbert
Director, Interoperability Operations and Partnerships
Chris McIntyre
Sr. Program Manager, RQNC Operations
Recent News
2024-04-07
Company data provided by crunchbase
