Cotiviti - US
Content Solutions Analyst I
This job is now closed
Job Description
- Req#: 11815
Employer Industry: Healthcare Services
Why Consider this Job Opportunity:
- Salary up to $115,000
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on clinical operations and content
- Competitive benefits package, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, and generous Paid Time Off (PTO)
What to Expect (Job 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
- 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
What is Required (Qualifications):
- BS in Nursing, Pharmacist (BSPharm or PharmD), Off-shore Medical or Pharmacy degree (MBBS or higher), or 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
- 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
How to Stand Out (Preferred Qualifications):
- 0-2 years of experience as an Rx Technician or Customer Service Representative in a healthcare-related service
#HealthcareServices #ClinicalOperations #MedicalPolicy #CareerOpportunity #CompetitivePay
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Cotiviti is a solutions and analytics company leveraging unparalleled clinical and financial datasets to deliver insight into the healthcare system’s performance.
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