[Remote] Content Solutions Analyst I

Note: The job is a remote job and is open to candidates in USA. Cotiviti is a healthcare solutions company, and they are seeking a Content Solutions Analyst I to join their clinical operations and content team. The role involves researching, ensuring quality, and analyzing medical policies while providing support across various solutions in Payment Policy Management.ResponsibilitiesFamiliarity with claims payment and reimbursement methodologies as well as medical policy rules and editsAbility to analyze complex data and synthesize it for customer and internal consumptionAbility to work well both independently and collaboratively, in a fast-paced and demanding environmentEffective at managing timelines and multiple projects with high accuracy and attention to detailProvide coding, claims processing and industry expertise to help create clinical coding policy or pharmacy claims editing policyResponsible for writing business logic for new rules and enhancements by translating industry references into Cotiviti policyProvide input on any new, or complex enhancements to the rule engine developers as well as system architectsWork within the ART, specifically providing guidance and input to TPO’s/developers during grooming sessionsWork with Product and the Go to Market teams, to provide coding and clinical expertise for new policy rolloutEnsure internal Cotiviti operational teams have a clear vision and understanding of the content solutions roadmap to ensure lock step on incoming workThis position requires maximum guidance from mentors and leadershipPerform multi-faceted analytics for data and report analysis with minimal directionSkillsBS in NursingPharmacist (BSPharm or PharmD)Off-shore Medical or Pharmacy degree (MBBS or higher)Other Bachelors degree (or equivalent work experience)RHIA, RHIT, CPC, CPC-H, CCS-P, SAFe, CPhT OR willingness to obtain certification within one year of employment3 years in clinical/retail setting as nurse, pharmacist, or physician, OR 3 years clinical coding in payer settingAn additional 3 years research experience related to coding (CPT, HCPCS, ICD, NDC) OR at least 3 years in an internal Cotiviti role (CPM, CSM, Content Analyst, etc.)5 years previous experience in detailed rule requirement gathering, rule development, and collaborating on software enhancements requiredStrong analytical, critical thinking and problem-solving skillsProficiency in Microsoft Office SuiteExcellent interpersonal, verbal and written communication skillsExperience supporting Behavioral Health and/or Laboratory payment integrity rule development, including coding research and rule logic applicationBenefitsMedicalDentalVisionDisabilityLife insurance coverage401(k) savings plansPaid family leave9 paid holidays per year17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with CotivitiCompany OverviewCotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. It was founded in 1979, and is headquartered in South Jordan, UT, US, with a workforce of 5001-10000 employees. Its website is http://www.cotiviti.com.Company H1B SponsorshipCotiviti has a track record of offering H1B sponsorships, with 23 in 2026, 165 in 2025, 118 in 2024, 90 in 2023, 102 in 2022, 72 in 2021, 67 in 2020. Please note that this does not guarantee sponsorship for this specific role.