Content Analyst II (Medicaid)

Cotiviti; United States; On-site; USD 75,000 - 103,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) savings plan with match

Paid holidays and PTO

Job summary

Cotiviti is seeking a Content Analyst II to join the clinical operations and content team. You will research, QA, and analyze new medical policies, expand the policy library, and focus on Medicaid. You’ll translate industry references into Cotiviti policy and mentor newer staff.

The role requires clinical or coding experience, strong analytical and communication skills, and the ability to work independently in a fast-paced environment. Base compensation ranges with strong benefits are offered.

Qualifications

• Active professional license as RN (BSN preferred) or Pharmacist or healthcare bachelor’s degree.
• Professional certification (RHIA/RHIT/CPC variants) preferred or obtainable within 1 year.
• Minimum 5–6 years of clinical or coding experience in payer/clinical setting.
• 3+ years of internet-based research related to CPT/HCPCS/ICD/NDC codes.

Responsibilities

• Provide coding and industry expertise to create and maintain clinical coding edits.
• Write business logic for new rules by translating references into policy.
• Review medical policies and keep policy library current.
• Collaborate with client teams on coding and clinical inquiries, challenges, or appeals.
• Own and be accountable for assigned medical policies.
• Perform multi-faceted analytics on data and reports with minimal direction.
• Mentor and train new staff.
• QA policy reviews and research requests for accuracy.
• Maintain knowledge of Cotiviti content, best practices, and policies.

Skills

Clinical coding knowledge

Analytical thinking

MS Office proficiency

Communication skills

Education

Registered Nurse license (RN)

Pharmacist degree (BSPharm/PharmD)

Bachelor's degree in healthcare or related field

MBBS or equivalent offshore medical degree

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. 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 ourCareers 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.