Cotiviti · 16 hours ago
Content Solutions Analyst I
United States
Full-time
Remote
Mid, Senior Level
$95K/yr - $115K/yr
5+ years expCotiviti is a healthcare analytics company, and they are seeking a Content Solutions Analyst I to be part of their clinical operations and content team. The role involves researching, ensuring quality, and analyzing opportunities related to medical policies, while also supporting various payment policy management solutions.
Information Technology & Services
Responsibilities
Responsible for the research, quality assurance, and opportunity analysis associated with new medical policies
Review and analyze current medical policies and assist in the research necessary to define additional logic and algorithms to expand the Cotiviti payment policy library
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 lock step on incoming work
Perform multi-faceted analytics for data and report analysis with minimal direction
Qualification
Required
BS in Nursing
Pharmacist (BSPharm or PharmD)
Off-shore Medical or Pharmacy degree (MBBS or higher)
Other Bachelors degree (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 payer setting
An additional 3 years 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 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
Preferred
Experience supporting Behavioral Health and/or Laboratory payment integrity rule development, including coding research and rule logic application
Benefits
Medical
Dental
Vision
Disability
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 that improve the quality and sustainability of healthcare 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
2025 (165)
2024 (118)
2023 (90)
2022 (102)
2021 (72)
2020 (67)
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
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