Medicaid Policy & Coding Analyst II

Cotiviti; Northern (KY); Hybrid; USD 75,000 - 103,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

401(k)

Paid time off

Job summary

Cotiviti is seeking a Content Analyst II to support the clinical operations and content team with research, quality assurance, and opportunity analysis for new medical policies. The role focuses on Medicaid while expanding the payment policy library through policy logic and data analysis.

The position requires clinical experience, policy knowledge, and strong communication. Base compensation ranges from $75,000 to $103,000 per year, with comprehensive benefits and PTO.

Qualifications

• 5+ years of clinical experience as a nurse, pharmacist, or physician OR 6+ years in clinical coding in a payer setting.
• 3+ years of internet-based research related to codes (CPT, HCPCS, ICD, or NDC).
• Knowledge of Medicaid guidelines is highly preferred.
• Proficiency with Microsoft Office suite and strong analytical skills.

Responsibilities

• Provide coding and industry expertise to create and maintain clinical coding edits.
• Write business logic for new rules and enhancements by translating references into Cotiviti policy.
• Review and update medical policies to keep the policy library current.
• Collaborate with client teams to address inquiries about clinical rules and policies.
• Own assigned medical policies and ensure timely delivery.
• Perform multi-faceted data and report analyses with minimal direction.
• Mentor and train new staff.
• QA policy reviews, logic revisions, and research requests for accuracy.
• Maintain up-to-date knowledge of Cotiviti content and best practices.

Skills

Analytical thinking

Research

Communication skills

Microsoft Office

Education

RN (BSN preferred)

Pharmacist (BSPharm or PharmD)

Healthcare-related Bachelor's

MBBS or higher

Job description

Cotiviti is seeking a Content Analyst II to support the clinical operations and content team with research, quality assurance, and opportunity analysis for new medical policies. The role focuses on Medicaid while expanding the payment policy library through policy logic and data analysis.

The position requires clinical experience, policy knowledge, and strong communication. Base compensation ranges from $75,000 to $103,000 per year, with comprehensive benefits and PTO.