Content Solutions Analyst I

🕒 Maio 6

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $95.000 - $115.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🧐 Analista de Negócios

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

Candidatar-se

Encontrar Vagas Remotas Similares

Receber Emails de Vagas Remotas

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo

Cotiviti

SiteLinkedInTodas as Vagas

5001 - 10000 funcionários

⚕️ Seguro de Saúde

💳 Fintech

🤖 Inteligência Artificial

Healthcare Insurance • Fintech • Artificial Intelligence

Cotiviti é uma empresa de tecnologia e análise em saúde que se especializa em melhorar a precisão e o desempenho dos pagamentos por meio de soluções avançadas de análise de dados. Eles se associam a planos de saúde, agências governamentais e provedores de serviços de saúde para fornecer insights que aprimoram a qualidade e a eficiência na prestação de cuidados. Com soluções como ajuste de risco, gerenciamento de políticas de pagamento e engajamento de membros, a Cotiviti busca otimizar os resultados financeiros e clínicos para o ecossistema de saúde.

Descrição

• 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. • Perform multi-faceted analytics for data and report analysis with minimal direction.

🎯 Requisitos

• 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. • 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. • Experience supporting Behavioral Health and/or Laboratory payment integrity rule development, including coding research and rule logic application, is preferred. • Strong analytical, critical thinking and problem-solving skills. • Proficiency in Microsoft Office Suite. • Excellent interpersonal, verbal and written communication skills.

🏖️ Benefícios

• medical, dental, vision, disability, and life insurance coverage • 401(k) savings plans • paid family leave • 9 paid holidays per year • 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti