Enable job alerts via email!
Content Solutions Analyst I (FWA)
Cotiviti
United States
On-site
USD 95,000 - 115,000
Full time
Boost your interview chances
Create a job specific, tailored resume for higher success rate.
Job summary
A leading company in healthcare is seeking a Content Solutions Analyst I (FWA) to join their clinical operations team. The role involves research, analysis, and management of coding edits related to fraud, waste, and abuse conditions. Ideal candidates will bring strong data analysis skills, coding expertise, and experience in the healthcare sector. This position offers a competitive salary and comprehensive benefits, including healthcare, 401(k), and paid time off.
Benefits
Qualifications
- 5 years practical experience required.
- 3+ years in internet-based research relevant to coding.
- Healthcare experience with medical claims processing is necessary.
Responsibilities
- Provide coding and industry expertise for clinical coding edits.
- Analyze and maintain clinical coding rules.
- Aggregate and interpret results from large datasets.
Skills
Education
Tools
Job description
Join to apply for the Content Solutions Analyst I (FWA) role at Cotiviti
1 week ago Be among the first 25 applicants
Join to apply for the Content Solutions Analyst I (FWA) role at Cotiviti
Get AI-powered advice on this job and more exclusive features.
Overview
The Fraud, Waste & Abuse (FWA) Content Solutions Analyst is a key member of the clinical operations and content team responsible for the research, development, and quality assurance, associated with new FWA conditions. In addition, this position will be responsible for review and analysis of current conditions and assisting in the research necessary to ensure conditions stay current.
Overview
The Fraud, Waste & Abuse (FWA) Content Solutions Analyst is a key member of the clinical operations and content team responsible for the research, development, and quality assurance, associated with new FWA conditions. In addition, this position will be responsible for review and analysis of current conditions and assisting in the research necessary to ensure conditions stay current.
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.
- Understand data structures and warehousing, with the ability to create, use, and interpret complex database queries. Aggregate, filter, and tabulate results from large datasets.
- Work with the client teams to provide coding and clinical expertise for customer and provider inquiries, questions, challenges or appeals of clinical rules.
- Assumes full ownership and accountability for creation and accuracy rules.
- Understand standard statistical metrics and how they are calculated. Be able to clearly explain these concepts to stakeholders.
- Performs multi-faceted analytics for data and report analysis with minimal direction.
- Understand aberrant billing behavior, clinical rationale, and standard elements of medical claims; translate logic into scripting language for execution.
- Train and support internal teams on rule logic, parameters, and execution processes, with the ability to communicate technical details in concise, easily understandable terms to the appropriate audience.
- Maintains current knowledge-base of industry and Cotiviti content, best practices, applications, procedures and policies.
- Present information and ideas in a thoughtful and compelling manner; be clear and concise in verbal and written communications. Share information freely and speak openly and honestly. Seek to understand the perspectives of others.
Education & Experience:
- Bachelor's degree with quantitative and/or programming focus (Analytics, Computer Science, Statistics, Mathematics, Economics, or Accounting) and 5 years of practical experience.
- 3+ years of experience in internet-based research as it relates to codes (CPT, HCPCS, ICD or NDC).
- 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.
- Excellent interpersonal, verbal and written communication skills.
- 2+ years of experience working with large datasets.
- Hadoop experience preferred.
- Experience analyzing and presenting data with strong spreadsheet and database query experience.
- Advanced SQL skills required.
- Hive, Spark, Scala skills preferred.
- Experience with or ability to learn various applications, including Git, Oracle SQL Developer, Tableau, Cloudera Hadoop, and proprietary software.
- Healthcare experience pertaining to medical claims processing is required.
- Ability to learn and quickly absorb new material.
- Strong analytical, quantitative, written, and interpersonal skills.
- Experience working in an Agile delivery framework (SAFe for Teams preferred).
- 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).
- Communicating with others to exchange information.
- Assessing the accuracy, neatness, and thoroughness of the work assigned.
- 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 expected.
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: 05/30/2025
Applications are assessed on a rolling basis. We anticipate that the application window will close on 07/30/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.
#senior
- Seniority levelMid-Senior level
- Employment typeFull-time
- Job functionAnalyst
- IndustriesHospitals and Health Care, Insurance, and Financial Services
Referrals increase your chances of interviewing at Cotiviti by 2x
Fort Washington, PA $90,000.00-$120,000.00 6 days ago
Arlington, VA $46,000.00-$49,000.00 1 week ago
United States $63,000.00-$68,000.00 1 week ago
United States $74,000.00-$80,000.00 2 weeks ago
United States $53,200.00-$91,800.00 1 week ago
United States $85,000.00-$104,000.00 4 weeks ago
United States $156,000.00-$184,000.00 4 days ago
United States $75,000.00-$95,000.00 3 days ago
United States $87,700.00-$120,560.00 1 week ago
United States $60,000.00-$90,000.00 2 weeks ago
United States $120,000.00-$130,000.00 10 minutes ago
United States $90,000.00-$120,000.00 19 hours ago
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
'/%3e%3cpath%20d='M101.744%2012.4726L102.894%2016.1947L99.0021%2013.2201L101.744%2012.4726ZM105.3%208.40937H100.488L99.0026%203.59473L97.5116%208.41047L92.7%208.40385L96.5965%2011.3834L95.1055%2016.1942L99.0021%2013.2196L101.408%2011.3834L105.3%208.40992V8.40937Z'%20fill='white'/%3e%3cdefs%3e%3clinearGradient%20id='paint0_linear_5593_1381'%20x1='90'%20y1='9.44471'%20x2='99'%20y2='9.44471'%20gradientUnits='userSpaceOnUse'%3e%3cstop%20stop-color='%2300AD70'/%3e%3cstop%20offset='0.998594'%20stop-color='%2300B67A'/%3e%3cstop%20offset='1'%20stop-color='%23DCDCE6'/%3e%3c/linearGradient%3e%3c/defs%3e%3c/svg%3e){kind=small}
job faster
