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About the role
Key responsibilities & impact- Provide coding and industry expertise to help create and maintain clinical coding edits
- Assist with research to identify opportunities for new medical policies
- Reviews and identifies changes to medical policies to maintain accurate library
- Work with QA to create and execute test cases to validate policy changes
- Provide coding and clinical expertise for customer inquiries or appeals
- Create and maintain documentation for Cotiviti’s medical policy library
- Maintain current knowledge-base of industry and Cotiviti content
- Complete all responsibilities as outlined on annual Performance Plan
- Complete all special projects and other duties as assigned
Requirements
What you’ll need- Bachelor's degree or 4 years equivalent experience
- CPC or equivalent coding certification required if no degree
- Additional 2 years clinical coding experience, preferably in payer setting
- High level proficiency in Microsoft Office
- Experience in internet-based research as it relates to codes (CPT, HCPCS, ICD, or NDC) preferred
- Familiarity with claims payment and reimbursement methodologies
- Experience with databases and data manipulation
- Ability to analyze complex data and synthesize it
- Ability to work independently and collaboratively in fast-paced environment
- Strong analytical, critical thinking and problem-solving skills
- Excellent interpersonal, verbal and written communication skills
- Ability to write business requirement documents
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- Disability insurance
- Life insurance coverage
- 401(K) savings plans
- Paid family leave
- 9 paid holidays per year
- Paid Time Off (PTO) ranging from 17-27 days a year
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical codingCPTHCPCSICDNDCdata manipulationtest case creationpolicy documentationmedical policy researchcoding edits
Soft Skills
analytical skillscritical thinkingproblem-solvinginterpersonal skillsverbal communicationwritten communicationindependent workcollaborative worksynthesis of complex dataability to manage fast-paced environment
Certifications
Bachelor's degreeCPC certification
