Content Analyst II – Drug and Biological Policy

Cotiviti

Content Analyst II in drug and biological policy, ensuring quality and maintenance of D&B policies at Cotiviti. Provide clinical expertise and own coding processes for policy enhancements.

Posted 6/18/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $100,000 - $135,000 per yearWebsite

ATS Keywords

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Hard Skills

clinical codingbusiness logicmedical policydrug information codingCPTHCPCSICDNDCclaims payment methodologiesdata analysis

Soft Skills

mentoringcollaborationtime managementattention to detailanalytical skillscritical thinkingproblem-solvingcommunication skills

Tools & Technologies

Microsoft OfficeExcelPivot tables

Certifications & Qualifications

Pharmacist licenseAHIMA certificationAAPC certification

Industry Keywords

clinical expertisepolicy reviewsprior authorizationhealth plan settingbest practices

About the role

Key responsibilities & impact

Provide coding and industry expertise to help create and maintain clinical coding edits.
Responsible for writing business logic for new rules and enhancements by translating industry references into Cotiviti policy.
Reviews and identifies changes to D&B policies in order to maintain an accurate and current medical policy library.
Work with the client teams to provide coding and clinical expertise for customer inquiries, questions, challenges or appeals of clinical rules.
Assumes full ownership and accountability for assigned D&B policies.
Help mentor and train any new team members.
Assist other team members when there are questions regarding policy reviews, logic revisions and research requests performed by others to ensure accuracy.
Maintains current knowledge of industry and Cotiviti content, best practices, applications, procedures and policies.
Complete all responsibilities as outlined in the annual performance review and/or goal setting.
Complete all special projects and other duties as assigned.

Requirements

What you’ll need

Active professional license as a Pharmacist (BSPharm or PharmD)
Professional certification (AHIMA or AAPC) preferred or willingness to pass certification exam within one year of employment
5+ years of experience as a pharmacist with at least three years of experience in a specialty, clinical, or bedside setting.
At least three years’ experience in medical policy or prior authorization in a health plan setting preferred
Experience in internet-based research as it relates to drug information and coding (CPT, HCPCS, ICD, or NDC)
Familiarity with claims payment and reimbursement methodologies
Ability to analyze data and synthesize it for internal consumption
Ability to work well both independently and collaboratively
Effective at managing timelines and multiple projects with high accuracy and attention to detail
Strong analytical, critical thinking, and problem-solving skills
Proficiency in Microsoft Office suite. Preferred knowledge of Excel, Pivot table, functions to analyze data
Excellent interpersonal, verbal and written communication skills

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Disability insurance
Life insurance
401(K) savings plans
Paid family leave
9 paid holidays per year
17-27 days of Paid Time Off (PTO) per year