Content Analyst II

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver coding and industry knowledge to assist in the development and maintenance of clinical coding edits.

• Accountable for formulating business logic for new rules and enhancements by converting industry references into Cotiviti policy.

• Evaluate and pinpoint modifications to medical policies to ensure a precise and up-to-date medical policy library.

• Collaborate with client teams to offer coding and clinical insight for customer and provider inquiries, questions, challenges, or appeals related to clinical rules.

• Take full ownership and responsibility for designated medical policies.

• Conduct comprehensive analytics for data and report assessment with minimal guidance.

• Mentor and train newly hired staff members.

• Execute quality assurance on policy reviews, logic modifications, and research requests performed by others to guarantee accuracy.

• Keep abreast of the latest industry trends and Cotiviti content, best practices, applications, procedures, and policies.

⛳️ Requirements

• Current professional license as a Registered Nurse (BSN preferred), Pharmacist (BSPharm or PharmD), Bachelor's degree (healthcare-related field preferred), or Offshore Medical Degrees (MBBS or higher).

• Preferred professional certification (RHIA, RHIT, CPC, CPC-H, CPC-P, or CCS-P) or willingness to obtain certification within one year of employment.

• At least 5 years of experience in a clinical environment as a nurse, pharmacist, or physician, or a minimum of 6 years of clinical coding experience, ideally in a payer setting.

• A minimum of 3 years of experience in internet-based research related to codes (CPT, HCPCS, ICD, or NDC).

• Understanding of claims payment and reimbursement methodologies, as well as medical policy rules and edits.

• Capability to analyze complex data and synthesize it for both customer and internal use.

• Ability to perform well both independently and as part of a team, in a fast-paced and high-demand environment.

• Proficient in managing timelines and multiple projects with a high degree of accuracy and attention to detail.

• Strong analytical, critical thinking, and problem-solving abilities.

• Proficient in the Microsoft Office suite.

• Exceptional interpersonal, verbal, and written communication skills.

🏝️ Benefits

• Medical, dental, vision, disability, and life insurance coverage.

• 401(K) savings plans.

• Paid family leave.

• 9 paid holidays each year.

• 17-27 days of Paid Time Off (PTO) annually, based on specific level and length of service.