Job Information
COTIVITI, INC. Content Solutions Analyst I in SOUTH JORDAN, Utah
Content Solutions Analyst I
Job Locations
US-Remote
ID
2025-14288
Category
Clinical
Position Type
Full-Time
Overview
The Content Solutions Analyst I is a key member of the clinical operations and content team responsible for the research, quality assurance, and opportunity analysis associated with new medical policies. In addition, this position will be responsible for review and analysis of current medical policies and assisting in the research necessary to define additional logic and algorithms to expand the Cotiviti payment policy library.
While this team has several areas of expertise, we will be looking to fill this role with a nurse/coder with inpatient DRG experience.
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
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
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
Provide input on any new, or complex enhancements to the rule engine developers as well as system architects
Work within the ART, specifically providing guidance and input to TPO's/developers during grooming sessions
Work with Product and the Go to Market teams, to provide coding and clinical expertise for new policy rollout
Ensure internal Cotiviti operational teams have a clear vision and understanding of the content solutions roadmap to ensure lock step on incoming work
This position requires maximum guidance from mentors and leadership
Perform multi-faceted analytics for data and report analysis with minimal direction
Qualifications
Education and Certification:
BS in Nursing
Pharmacist (BSPharm or PharmD)
Off-shore Medical or Pharmacy degree (MBBS or higher)
Other Bachelors degree (or equivalent work experience)
AND
- RHIA, RHIT, CPC, CPC-H, CCS-P, SAFe, CPhT OR willingness to obtain certification within one year of employment
Experience:
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 (CPM, CSM, Content Analyst, etc)
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
Job Demands:
Must have flexibility and willingness to participate in the work processes of an international organization
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.
No adverse... For full info follow application link.
E ual Opportunity Employer/Protected Veterans/Individuals with Disabilities