Note: The job is a remote job and is open to candidates in USA. Cotiviti is a company focused on clinical operations and content management, and they are seeking a Content Analyst II to join their team. This role involves researching and analyzing medical policies, providing coding expertise, and ensuring the accuracy of the policy library.

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

Skills

• 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)
• 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
• Professional certification (RHIA, RHIT, CPC, CPC-H, CPC-P, or CCS-P) preferred or willing to pass certification exam within one year of employment

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 Overview

Company H1B Sponsorship