Content Analyst II

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.
• Absorbs 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.

Qualifications

• 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.

Job Demands

• This is a work-at-home position.
• Access to high-speed internet is required (all other equipment will be provided).
• Must be able to sit and use a computer keyboard for extended periods of time.
• Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones.
• After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent).

Mental Requirements

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements And Working Conditions

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Pay and Benefits

• Base compensation ranges from $75,000 to $103,000 per year.
• Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(K) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.