Medicaid Policy Analyst II - Clinical Coding & Analytics

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

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.