Job Description
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. 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. This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job change. 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 (RH
