Job title: Clinical Content Analyst
Company: Cotiviti
Job description: Overview
JOB RESPONSIBILITIES
- Coordinates with US Research Medical Directors to manage the integrity of the Payment Policy Library and ensure the Payment Policy Library is accurate and up-to-date.
- Supports the scheduled review process for State Medicaid policies in collaboration with the US Client Medical Directors and/or Client Policy Managers.
- Responds to the research related queries pertaining to the medical policy raised by internal personnel or client including but not limited to:
i. Questions about claims edits that enforce medical policy.
ii. Interpretation of how claims edits relate to policy statements.
iii. Recommendations regarding modifications of edits.
- Supports quarterly and annual updates in collaboration with the US Research Medical Directors.
- Supports the scheduled review process for global and specialty policies in collaboration with the US Research Medical Directors.
- Works diligently to meet and exceed productivity and quality benchmarks
- Takes charge of ongoing learning and development and participates in relevant training and development activities
- Collaborates well with global research team members to advance the Research agenda.
- Supports other departments and client teams within Cotiviti on assigned project work.
- Supports other Research related activities as assigned
ATTRIBUTES AND BEHAVIORS
- Develops and maintains positive working relationships with others.
- Shares ideas and information.
- Assists colleagues unprompted.
- Takes pride in the achievement of team objectives.
- Has credibility with peers and senior managers.
- Self-motivated – driven to achieve results.
- Works with a sense of urgency.
- High customer service ethic – is passionate about meeting customer expectations and improving service levels.
- Keeps pace with change – acquires knowledge/skills as the business evolves.
- Handles confidential information with sensitivity.
RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS
- Medical degree (MBBS or BAMS or BHMS; Diploma in Specialties or MD preferred) OR Certified medical coder with a clinical background with minimum 2 years of experience in Coding.
- Clearance of all major exams (SSC, HSC, qualifying degree) in first attempt.
- Clearance of aptitude test for analytical, quantitative, and logical reasoning skills.
- Clearance of English assessment test for both written and verbal skills.
- Practical clinical experience working in a hospital/office or nursing home strongly preferred.
- Experience in US healthcare specifically billing, coding and health plan operations strongly preferred.
- Knowledge of ICD-10 coding preferred.
SKILLS & COMPETENCIES
- Strong analytical, critical thinking and problem solving skills.
- Excellent verbal and written communication skills.
- Excel proficiency.
- Strong organizational skills and adaptive capacity for rapidly changing priorities and workloads.
- Ability to work well independently and maintain focus on a topic for prolonged periods of time.
- Comfort in working with team members that are remote and located in the US, India or other geographies.
- Ability to work within a matrix organization.
JOB DEMANDS
- Ability to work seated at a computer for long periods of time.
- Candidate should be ready to work in different shifts, including night shift.
KEY CONSTITUENTS
- No direct reports.
- Works with all Cotiviti business teams but especially Research (Medical Directors & Research Analysts), Medical Policy and Client Services.
Expected salary:
Location: Pune, Maharashtra
Job date: Sun, 25 Sep 2022 07:06:29 GMT
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