Cotiviti · 6 hours ago
Content Solutions Analyst I (CPE)
United States
Full-time
Remote
Entry Level
$95K/yr - $115K/yr
3+ years exp
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Responsibilities
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.
Provide coding, claims processing, and industry expertise to help create clinical coding policy or pharmacy claims editing policy.
Responsible for writing business logic for new rules and enhancements by translating industry references into Cotiviti policy.
Provide input on any new, or complex enhancements to the rule engine developers as well as system architects.
Work within the ART, specifically providing guidance and input to TPO’s/developers during grooming sessions.
Work with Product and the Go to Market teams, to provide coding and clinical expertise for new policy rollout.
Ensure internal Cotiviti operational teams have a clear vision and understanding of the content solutions roadmap to ensure lockstep on incoming work.
This position requires maximum guidance from mentors and leadership.
Perform multi-faceted analytics for data and report analysis with minimal direction.
Complete all responsibilities as outlined in the annual performance review and/or goal setting.
Complete all special projects and other duties as assigned.
Must be able to perform duties with or without reasonable accommodation.
Qualification
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Required
BSN, Pharmacist (BSPharm or PharmD), Bachelors, Off-shore Medical or Pharmacy degree (MBBS or higher) (or equivalent work experience)
RHIA, RHIT, CPC, CPC-H, CCS-P, SAFe, CPhT OR willingness to obtain certification within one year of employment
3 years in clinical/retail setting as nurse, pharmacist, or physician, OR 3 years clinical coding in a payer setting
An additional 3 years of research experience related to coding (CPT, HCPCS, ICD, NDC) OR at least 3 years in an internal Cotiviti role (CPM, CSM, Content Analyst, etc.)
5 years of previous experience in detailed rule requirement gathering, rule development, and collaborating on software enhancements required
Strong analytical, critical thinking, and problem-solving skills
Proficiency in Microsoft Office Suite
Excellent interpersonal, verbal, and written communication skills
Must have flexibility and willingness to participate in the work processes of an international organization
Benefits
Medical, dental, vision, disability, and life insurance coverage
401(k) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti
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.
5001-10000 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
Represents job field similar to this job
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
