内容分析师 II (医疗补助)
Content Analyst II (Medicaid)
职位概述
内容分析师II是临床运营和内容团队的关键成员，负责与新医疗政策相关的研究、质量保证和机会分析。此外，该职位还将负责对现有医疗政策进行审查和分析，并协助进行必要的研究，以定义额外的逻辑和算法，扩展Cotiviti支付政策库。该职位的重点将放在我们的医疗补助（Medicaid）团队上。
职责
- 提供编码和行业专业知识，帮助创建和维护临床编码编辑。
- 负责通过将行业参考文献转化为Cotiviti政策，编写新规则和增强功能的业务逻辑。
- 审查并识别医疗政策的变化，以保持医疗政策库的准确性和时效性。
- 与客户团队合作，为客户提供编码和临床专业知识，处理与临床规则相关的客户或供应商查询、问题、挑战或申诉。
- 对所分配的医疗政策承担全部责任和问责。
- 在最少指导的情况下进行多方面的数据分析和报告分析。
- 指导和培训新员工。
- 对他人进行的政策审查、逻辑修订和研究请求进行质量保证，以确保准确性。
- 保持对行业和Cotiviti内容、最佳实践、应用、流程和政策的最新了解。
任职要求
- 需具备以下学位之一：
- 注册护士（RN）专业执照（本科护理学士学位优先）。
- 药剂师（药学学士或药学博士）。
- 学士学位（医疗相关专业优先）。
- 海外医学学位（MBBS或更高）。
- 优先考虑专业认证（RHIA、RHIT、CPC、CPC-H、CPC-P或CCS-P），或愿意在入职一年内通过认证考试。
- 至少5年在临床环境中的工作经验，作为护士、药剂师或医生，或至少6年的临床编码经验，最好是在保险公司工作。
- 至少3年基于互联网的研究经验，涉及编码（CPT、HCPCS、ICD或NDC）。
- 熟悉医疗补助指南者优先。
- 熟悉理赔支付和报销方法，以及医疗政策规则和编辑。
- 能够分析复杂数据，并将其整理为客户提供和内部使用的资料。
- 能够独立和协作地工作，在快节奏环境中表现出色。
查看英文原文
Overview
The Content Analyst II 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. Specific focus for this role will be on our Medicaid team.
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.
- Assumes 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.
- Maintains current knowledge-base of industry and Cotiviti content, best practices, applications, procedures, and policies.
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).
- Knowledge of Medicaid guidelines highly 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.
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 environmental conditions are expected.
- After hours and/or weekend work required where necessary for major deliverables/deadlines (not consistent).
Base compensation ranges from $75,000 to $103,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.
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. For information about our benefits package, please refer to our Careers page.
Date of posting: 9/10/2026
Applications are assessed on a rolling basis. We anticipate that the application window will close on 11/10/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.
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Originally posted on Himalayas