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Key Responsibilities:
- Serve as a coding and medical payment policy expert, directing the Medical Policy Committee and developing client relationships.
- Analyze client data, select medical policy opportunities, and prepare presentations to support policy adoption.
- Coordinate with internal teams and client medical directors to validate editing and financial impact.
Qualifications:
- Bachelor's degree in relevant field plus professional coder certification (CPC, CCS, etc.).
- 7-10 years of experience, with minimum 5 years in claim payment adjudication or medical payment editing.
- Strong presentation, communication, organizational, and problem-solving skills, with ability to analyze complex data.
Compensation & Benefits:
- Base salary range of $120,000 to $145,000 per year, plus discretionary bonus eligibility.
- Comprehensive benefits package including medical, dental, vision, disability, life insurance, 401(k), paid family leave, 9 paid holidays, and 17-27 days of PTO per year.
- Remote role within the continental US with occasional travel (10-20%).
Cotiviti
Cotiviti is a healthcare analytics company that partners with health plans to optimize payment accuracy and medical policy through data-driven solutions. The company employs a global workforce and fosters a collaborative, client-focused culture.