In the role of Content Enablement Analyst within our Clinical Chart Validation department, you will play a pivotal role in ensuring the accuracy and compliance of concept selection and development for both CMS (Centers for Medicare & Medicaid Services) and commercial clients. Your expertise in medical coding, auditing processes, organizational and prioritization skills, and meticulous attention to detail will support the development and maintenance of various projects that will assist in upholding impeccable standards, guaranteeing optimal payment integrity for healthcare industry clients. Additionally, your proficiency in technology and performance analytics including business reporting tools, Standard Operating Procedures (SOP) creation, and template development, are highly advantageous to this role.

• Demonstrates ability to maintain regulatory compliance standards. Monitor concept performance, criteria, and logic frequently to reflect any changes in legislation, rules, and policies. Ensure coding practices align with ICD-10, CPT, HCPCS Level II, and other relevant coding standards. Understands the importance of monitoring and implementing these updates in a timely manner.
• Identify coding discrepancies, errors, and potential compliance issues through in-depth analysis of selections.
• Communicate results and collaborate with senior team members and managers effectively.
• Proficiency in data entry/analysis and in manipulating large quantities of data with strong spreadsheet and database query knowledge is essential. Management and maintenance of reference tables, queries, and websites is required.
• Ability to create, deliver, and maintain basic client/internal reporting and performance analytics.
• Creation and maintenance of simplistic automated business tools, templates, and reporting products that promote department efficiency.
• Ability to work independently in a fast-paced environment with limited guidance, recognize and quickly shift priorities, and document progress and actions as required.
• Assist in development of improved processes and workflows, integrating new technology such as Artificial Intelligence.
• Coordinate Onboarding tasks and system access requests.
• Monitoring query input/output, performance outcomes, and investigation of discrepancies or variances.
• Completion of all special projects and other duties as assigned.
• Meeting attendance and participation required as per department and company standards.
• Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements

Education/Certification: 

• Bachelor’s degree in healthcare administration, associate degree in health information management, certification in Nursing, or related field preferred.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential preferred.

Experience: 

• Experience in medical billing or coding preferred.
• Proven experience in medical coding, performance analysis, or data analytics.
• Knowledge of commercial and CMS coding regulations, guidelines, and reimbursement policies.
• Strong analytical, quantitative, written, and interpersonal skills.
• Extremely well-organized and capable of handling multiple projects and ad-hoc requests simultaneously.
• Effective mentorship and training skills.

Technical Skills: 

• Advanced experience in Microsoft office suite (Excel including pivot tables/formulas, Word, Power Point, Vizio, and Access).
• Prior experience and proficiency with tools including Tableau, Power Pivot, Power Automate, etc. preferred.
• Basic SQL experience preferred

Other Competencies: 

• Effective communication skills to collaborate with cross-functional teams and clients.
• Ability to work independently and in a team-oriented environment.
• Strong problem-solving skills and ability to adapt to changing policies and procedures within the team, organization, or professional field.
• Enthusiasm related to professional development and learning about new industries, technologies, and market trends.
• Strong proactive attitude towards challenges.

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
• No adverse environmental conditions expected.

Base compensation ranges from $70,000 to $98,000. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. 

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 1/27/2025
Applications are assessed on a rolling basis. We anticipate that the application window will close on 3/1/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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