Content Analyst I

Posted Jan 13

Overview:

The Content Analyst is a key member of the Content Center of Excellence, responsible for the research and implementation of new and existing medical policies. In addition, the Analyst is responsible for review and analysis of Clinical Content metadata from national sources (CMS, CPT, ICD, etc..) that support the current medical policies in the Cotiviti payment policy library.

Responsibilities:

  • Provide coding and industry expertise to help create and maintain clinical coding edits.
  • Assist with research to identify opportunities for new medical policies.
  • Reviews and identifies changes to medical policies in order to maintain an accurate and current medical policy library
  • Work with QA to create and execute test cases to validate changes in policy.
  • Works with the Client Teams to provide coding and clinical expertise for customer inquiries, questions, challenges or appeals of medical policies.
  • Assist in creating and maintaining documentation for Cotiviti’s medical policy library.
  • Maintains current knowledge-base of industry and Cotiviti content, best practices, applications, procedures and policies
  • Completes all responsibilities as outlined on annual Performance Plan.
  • Completes all special projects and other duties as assigned.
  • Must be able to perform duties with or without reasonable accommodation.

Qualifications:

  • Active professional license as a Registered Nurse (BSN preferred) or Bachelor’s Degree in Healthcare related field or equivalent relevant experience.
  • 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 3 years of experience in a clinical setting as a nurse, pharmacist or physician OR minimum of 5 years clinical coding experience, preferably in a payer setting.
  • Experience in internet-based research as it relates to codes (CPT, HCPCS, ICD or NDC) preferred
  • 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.
  • Flexibility to travel outside the US based on business need is preferred.
  • 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)

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