Policy Integration Coordinator I

Overview

The Policy Integration Coordinator I position holds the primary responsibility for ensuring that each client’s initially chosen policy set & tables have been configured accurately based on the client’s decisions. Manages lower complexity projects. This includes copy of existing payer data, E&M over code, and payer termination projects.

Also loads table mappings for Clinical Chart Validation projects. The Policy Integration Coordinator I provides technical support related to payment policies to the Implementation MD, Implementation Service Director (ISD), and the client. Provides additional support to the Policy Integration II and III as needed.

Responsibilities

• Pulls presentation, capturing policy-related decisions, specifying their configuration, and ensuring that the policies are set up according to client specification.
• Provides support to Medical Directors and Implementation Team during client implementation regarding policy configuration issues. This includes research and issue management.
• Reviews initial testing and production files to determine if policies are functioning as expected to identify any potential issues.
• Communicates effectively to internal teams and clients.
• Manages project timeline effectively to meet monthly deadlines and notifies the appropriate individual(s) of risks to the timeline.
• Attends Policy Committee meetings and facilitate debriefing on client decisions.
• Complete all responsibilities as outlined on annual Performance Plan.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications

• Bachelor’s degree preferred or 1 year equivalent work experience.
• High standards with extreme attention to detail, and facilitation skills to ensure clear decisions.
• Works well under pressure and handles conflict well.
• Ability to work well independently and in a team environment.
• Ability to work within a matrix organization.
• Knowledge of CPT, ICD, HCPCS coding and basic medical terminology.
• Excellent verbal and written communication skills, projection of confidence, track record of getting things done through others (even those for whom there is no authority).
• Proficient with Microsoft Office Suite (Excel, Outlook, Power Point, Word)
• Professional with ability to properly handle confidential information.
• Ability to handle multiple tasks, prioritize and meet deadlines.
• Must have ability to positively handle/manage stress, such as high work volume and frequent change.

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 $25.00 to $32.00 per hour. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration.

Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.

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: 2/28/2025

Applications are assessed on a rolling basis. We anticipate that the application window will close on 4/28/2025, 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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