Client Service Analyst - Payment Integrity Operations (FWA)

Overview

The Client Service Analyst (CSA) ensures adequate support for the client-facing team on coding and policy as well as operational related activities. The CSA must be familiar with the day-to-day activities of the Client Policy Manager (CPM), Client Service Manager (CSM) and client-facing Medical Directors. The CSA also oversees the intake and development of client policy and claim-editing rules, partnering with the Content and Research & Development (R&D) teams to ensure rules are configured accurately and meet client requirements.

Responsibilities

• Assist with internal projects, take lead on larger client projects as needed with the ability to drive multiple projects/tasks, prioritize, and meet deadlines.
• Ability to effectively present information, respond to questions from peers, gather topics andschedule client and internal stakeholder meetings.
• Ensures technical documents and other deliverables such as rule intake forms, process guides,job aids, and operating instructions remain current.
• Provides support to new CSAs by shadowing and assisting in role-based training.
• Participates in software UAT as a Client Delivery representative.
• Oversees the intake and development of new and updated policy and claim-editing rules,coordinating with the Content and Research & Development (R&D) teams throughout the rulelifecycle to ensure rules are configured to meet client needs:
  • Performs intake of new and revised client rule requests, confirming requirements, effective dates, and supporting documentation before routing for development.
  • Partners with Content and R&D teams to translate client policy intent into configured rules, asking clarifying and follow-up questions to confirm intended outcomes.
  • Reviews new rule requests against the existing rule library to identify overlapping orsubstantially similar rules already in production, escalating conflicts for resolution.
  • Researches claims data and report output to validate rule logic, confirm expected rulebehavior, and support decisions during rule design and testing.
  • Investigates and resolves situations where a proposed rule conflicts with existing clientcustomizations or configuration.
  • Tracks rule requests through intake, development, testing, and production release,documenting status and decisions in the appropriate tracking application.
• Generates presentations for client and internal ad hoc change requests. For ad hoc requests the CSA documents and finalizes decisions in the appropriate application and creates the Project Request, attaching all documents and assigning to appropriate Operations Team member(s).
• Runs reports to identify and close Project Requests as defined by CPM/CSM after the production release lockdown each month.
• Reviews, analyzes, and responds to Policy and Operational Inquiries by defined desiredcompletion date. Communicates to the client team when the desired completion date needs to be adjusted due to complexity and/or additional research.
• Performs multi-faceted data and report analytics. Determines the applicable reports to run based on the client team inquiry. Analyzes the report output and provides accurate client or policy information based on thorough report analytics.
• Generates, modifies, and formats reports for ad hoc purposes which includes determining thenecessary parameters and building the report, performing analysis and summarizes findings to the client team.
• Enters client inquiries, report requests, and research requests into the designed softwareapplication (i.e., JIRA) for routing, tracking and completion.
• Manages Client Inquiry Log entries and provides reporting to the client team.
• Researches and examines client questions and drafts an accurate response to the client.
• Actively participates in team, department, business unit, and corporate meetings.

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 the requirements of the job change.

Qualifications

• B.S., B.A, in business or healthcare related field, or equivalent experience required.
• Requires a minimum of 2 years of related experience.
• Advanced knowledge of Excel (pivot tables, complex formulas, VLOOKUPs, statistical functions).
• Experience using AI coding assistants (e.g., Claude) to support rule build, testing, or automation tasks preferred.
• US Healthcare industry and claims analysis experience preferred.
• Excellent analytical skills with ability to troubleshoot problems and find root causes.
• Effective problem-solving skills.
• Professional with ability to properly handle confidential information.
• Ability to work well independently and in a team environment.
• Ability to handle multiple tasks, prioritize and meet deadlines.
• Excellent written and verbal communication skills.
• Attention to detail and accuracy.
• Organizational skills.
• Works with a sense of urgency.
• Ability to follow defined policies and procedures.
• Strong interpersonal skills.
• Desire and capacity to learn new concepts and software.

Cognitive/Mental Requirements:

• Ability to work in a fast-paced environment, effectively organize, plan, prioritize and meet deadlines; producing high-quality, error-free deliverables.
• Excellent written and verbal communication and interpersonal skills.
• Demonstrated success in developing strong, trust-based professional relationships with clients in multiple roles and levels.
• Ability to work with on-site and remote cross-functional product teams and customers.

Working Conditions and Physical Requirements:

• This remote role can be located anywhere in the continental US.
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or finger.
• Must be able to perform duties with or without reasonable accommodation.
• 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 $60,000 to $80,000 per year. 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: 9/30/2026

Applications are assessed on a rolling basis. We anticipate that the application window will close on 11/30/2026, 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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