Remote Client Policy Strategist

Cotiviti; Northern (KY); Hybrid; USD 78,000 - 106,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) plan

Paid family leave

Holidays & PTO

Job summary

Cotiviti is seeking a Client Policy Manager I to manage client payment policies, ensure accuracy, and act as a liaison between internal teams and client staff. The role is client-facing with a focus on service excellence and policy updates.

The candidate should have an RN license or healthcare degree with coding credentials, 3+ years of payer coding experience, and strong CMS policy knowledge. Remote work across the continental US is supported, with up to 20% travel.

Qualifications

• Active RN license or healthcare degree.
• Professional coder certification (CPC, CPC-H, CPC-P or CCS-P).
• Minimum of 3 years clinical coding experience in payer settings.
• Strong knowledge of healthcare claims payment policies and processing (CMS, Medicaid, ICD, CPT, HCPCS).
• Experience in claims adjudication or utilization review for managed care/health insurance.
• Experience in customer service or client management in healthcare.

Responsibilities

• Ensure integrity of the client medical policy set and update policies as needed.
• Prepare and present payment policy documents to clients; coordinate reviews with Medical Directors.
• Conduct research/analysis for medical policy items with guidance from Cotiviti team.
• Review policies for accuracy; communicate effectively with clients and Cotiviti team.
• Provide data/report analytics and apply project management to policy initiatives.
• Maintain client policy sensitivities in the Client Profile Workbook.
• Collaborate with internal/external client teams to deliver on policy requests.
• Support special projects and quarterly performance initiatives.

Skills

Healthcare policy knowledge

CMS guidelines

Data analysis

Customer service

Project management

Communication skills

Confidential information handling

Team collaboration

Education

RN license (BSN preferred) or healthcare degree

Professional coder certification (CPC, CPC-H, CPC-P or CCS-P)

Tools

Microsoft Office

Job description

Cotiviti is seeking a Client Policy Manager I to manage client payment policies, ensure accuracy, and act as a liaison between internal teams and client staff. The role is client-facing with a focus on service excellence and policy updates.

The candidate should have an RN license or healthcare degree with coding credentials, 3+ years of payer coding experience, and strong CMS policy knowledge. Remote work across the continental US is supported, with up to 20% travel.