A Payment Accuracy, Data Mining (DM) Specialist, is a member of the greater Data Mining Business Unit (BU). Cotiviti's Data Mining team configures custom claim reviews to investigate untapped billing compliance issues specific to regulations and contracted policies across product, market, and provider types.   A Payment Accuracy Data Mining (DM) Specialist is responsible for auditing client data and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Under direct supervision, identifies and inputs recovery claims, voids, or other over-underpayment types. Documents relevant facts,...

The Technical Product Owner is responsible for driving solution definitions that support business ideas and product concepts at a team and program level through gathering and translating testable requirements into application software solutions. The Business Analyst has deep domain knowledge, and strong experience in collaborating with a diverse team including product managers, software developers, testers, and teams such as Client Services, Operations, Clinical, Data Science, and Marketing.

The Product Marketing Director for the Retail Business Unit is responsible for developing and managing the strategic marketing objectives for Cotiviti’s business and financial solutions portfolio, including but not limited to, merchandise recovery audits, AP audits for commercial market, error prevention, and contract compliance. This portfolio includes a mix of services and software solutions. This role focuses on understanding the market landscape, competition, and buyer personas to create and successfully execute a market plan, support effective product launches, develop and maintain a portfolio of enablement materials, and drive lead generation and sales acceleration efforts.

The Implementation Director will guide the delivery of services and technology to one or more clients by planning, supporting and / or managing implementation activities from pre-sales support through production verification.

The Senior Manager, HR Business Partner, will be a member of a business unit and or functional leadership team and serve as a key business partner to provide strategic and tactical human resources leadership. This role will partner with other HR team members, such as talent acquisition, employee experience, operations, and total rewards. This role is responsible for driving HR initiatives that align with business objectives, enhance organizational performance, and foster a positive work environment. The Senior Manager, HRBP acts as a consultant on...

The Intern Technology Solutions Analyst is responsible for researching technologies and use cases for Cotiviti solutions. This internship role will report to the Director of Platform Strategy & Innovation and work on Portfolio Prospecting within the Innovation & Portfolio Management Center of Excellence (IPM). IPM Portfolio Prospecting reduces investment risk and improves speed to value through early exploratory validation, development, and delivery of solutions. Portfolio Prospecting is tasked with maintaining transparency into the strategic environment and positioning Cotiviti with validated long-term pathways to competitive advantage.  

The Sr. Manager, Audit Operations is responsible for leading the Clinical Chart Validation (CCV) audit operation, managing the audit team’s performance and productivity, ensuring client SLA’s and budget commitments are achieved, claim workflow is uninterrupted, and talent management is prioritized. This particular Sr. Manager role has expanded process improvement responsibilities across the CCV Audit including vendor management, NLP program oversight and serves as the lead on other process improvement initiatives designed to optimize team efficiency through automation and other means. This role will have 4-6 direct reports and up to 90 indirect reports.

The Coordination of Benefits (COB) & Data Mining (DM) Audit Support is a member of the greater Coordination of Benefits and Data Mining teams. This individual will efficiently and professionally handle daily administrative activities within the COB and DM departments to assist the audit to meet and exceed client expectations. This role requires exceptional verbal communication by audio as well as attentive attention to detail for data entry-related written communication and follow–ups for both internal and external client inquiries to achieve success in the generation of overpayments.

The Content Analyst is a key member of the Content Center of Excellence, responsible for the research and implementation of new and existing medical policies. In addition, the Analyst is responsible for review and analysis of Clinical Content metadata from national sources (CMS, CPT, ICD, etc..) that support the current medical policies in the Cotiviti payment policy library.

As an AI Program/Project Manager, you will play a pivotal role in driving the development and deployment of innovative AI/ML solutions. You will collaborate closely with cross-functional teams, including engineers, data scientists, and business stakeholders, to identify, prioritize, and deliver high-impact AI/ML products. You are data driven and influence our business strategy and technical priorities with that vision. This role will drive alignment between data

The Client Service Analyst (CSA) role 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 Team Lead Coder Coding Validation position will have responsibility for supervising a team of Coding Validation analysts or coders. Team Leaders ensure that the work of others meets productivity standards, quality and client guidelines. Primary responsibilities include queue management, work distribution, performance and production optimization, audit planning, coder interactions, training of new hires/existing staff, on appeals support while meeting SLA obligations. The Team Lead goal is to ensure the team audits client data on behalf of our clients, generating high quality payment determinations and displays professional skepticism that enhances the work performed in order to achieve success in position.

Cotiviti has multiple openings for full-time coders....these roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule.  

This Coding Validation Analyst I position will perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical knowledge and background to ensure appropriateness for reimbursement and will also respond to provider appeals. This position requires strong organizational skills and the ability to meet strict key performance indicators in a fast-paced work environment. Daily, substantive contact with internal staff.    This is a closely monitored productivity-driven role and can be done anywhere in the continental US (this is shift work and hours need to be flexible...this team runs 24 x 7)....

A Payment Accuracy, Coordination of Benefits (COB) Senior Specialist, is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is covered by two or more health plans. Individuals in the Senior Specialist role are passionate about what they do and are subject matter experts (SMEs) at identifying opportunities for strategic growth, reviewing, discovering, and validating substantial amounts of data, to deliver results and insights for our clients.

The Research Medical Director is a key member of the Clinical and Policy research development area at Cotiviti. The Research Medical Director is responsible for providing leadership guidance to the clinical teams and ensuring the Rules and policies are accurately interpreted and developed. This role is also responsible for analyzing, interpreting, and developing additional policies that will allow us to enhance our medical policy library. The Medical Director will guide both internal and external processes as related to Payment Policy Management polices and rules.   This is a...

Cotiviti Healthcare is the payment accuracy expert! We work with healthcare organizations to recover money, improve processes, strengthen relationships and maximize their value. As we continue to grow, we are seeking experienced Payment Accuracy Specialists to join our team. This is a great opportunity to join a well-established company with competitive pay, opportunities to develop professionally and excellent benefits.  

Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our healthcare recovery team as a Payment Accuracy Specialist 2.   

This is a hunter role in the healthcare payer space. Extensive experience calling on and selling to Health Plan “C” level executives, SVP Business Owners, procurement, VPs and directors is essential. Experience working in a leading Health Plan software and service vendor in the Payment Integrity space is required with specific experience selling Coordination of Benefits and/or Data Mining solutions being highly desired. We are looking for candidates across the US.

The Vice President, Sales is responsible for the development and strategic execution of annual sales plans to support the acquisition of new clients and sale of new solutions for the Cotiviti Retail division. This is a hunter role focused on hunting new business for Cotiviti’s Retail Payment Integrity Services and Solutions to the world’s largest retailers, e-commerce, and commercial enterprises. Demonstrated experience calling on and selling to “C” level executives, SVP Business Owners, CFO’s, Procurement, VPs, and Directors is essential.  Experience working in a disruptive software and services sector selling Data Analytics, Payment Integrity / Recovery Auditing services and...

At Cotiviti, we are custodians of data for our clients. Using their technical experience in ETL processes, Data Engineers ensure operational functions are occurring as expected. This includes but is not limited to managing data implementations, data integrations, data production, data quality, and data security.

The Generative AI Developer Intern focuses on researching and developing advanced healthcare informatics, particularly in the realm of Generative AI and emerging Artificial General Intelligence. It is designed to support improvements in healthcare treatment, payment, and operations. The intern will assist and take a primary role in developing, researching, creating analytical materials, and collaborating with various teams to drive AI-related projects.   We are currently looking for interns who can start in...

The Project Manager is a role within the Retail business unit who will work cross-function to help manage projects within this business unit. The role is responsible for managing the project from initiation to completion, plus defining ingestion, prioritization and reporting processes.  In this role you will partner with a cross functional team, including Marketing, Go-to-Market Effectiveness, Product, R&D, Operations, and other players to plan, organize and execute project plans.  

The Sr Data Scientist - Generative AI II will apply knowledge and expertise to real world problems to enable healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. With access to dedicated on premise and cloud based big data solutions, the team can work with a vast amount of structured and unstructured data including claims, membership, physician demographics, medical records and others to begin to solve some of the most pressing healthcare issues of our time. A Data Scientist at Cotiviti will be given the opportunity to work directly...

The Sr Staff AI Scientist- Generative AI will apply knowledge and experience to real world problems and seek to utilize their skills reduce the cost of healthcare and improve health quality and outcomes. With access to dedicated on premise and cloud based big data solutions, the team can work with a vast amount of structured and unstructured data including claims, membership, physician demographics, medical records and others to begin to solve some of the most pressing healthcare issues of our time. A Data Scientist at Cotiviti will be given the opportunity to work directly with a team of healthcare professionals including analysts, clinicians, coding specialists,...

The Staff Gen AI Scientist will apply knowledge and experience to real world problems and seek to improve health quality outcomes and reduce the cost of healthcare. With access to dedicated on premise and cloud based big data solutions, the team can work with a vast amount of structured and unstructured data including claims, membership, physician demographics, medical records and others to begin to solve some of the most pressing healthcare issues of our time. A Data Scientist at Cotiviti will be given the opportunity to work directly with a team of healthcare professionals including analysts, clinicians, coding specialists, auditors and innovators to set...

The Director of Engineering AI will drive our AI Platform design across all lines of business. The Director will be responsible for the development and execution of the AI platform and machine learning applications that will empower Cotiviti's Product Groups to deliver innovative AI-powered experiences to our customers.

The Manager Leave Programs leads the strategy, operations, compliance, and continuous improvement of the company’s leave and accommodation programs, including ADA, FMLA, Short-Term Disability (STD), Long-Term Disability (LTD), Paid Time Off (PTO), and applicable state and local leave regulations. This role owns vendor/TPA relationships and partners cross-functionally with HR, Employee Relations, Legal, Payroll, and Benefits to deliver a seamless employee experience, ensure regulatory compliance, and drive data-informed decisions. The Manager will

As a Senior Systems Engineer you will be responsible for resolving escalated service issues, coaching other engineers to resolutions, engineering and implementing complex projects, and for maintaining and overseeing the technology of their assigned areas. This includes VMWare, Windows, and Linux environments.   We are seeking a highly skilled Senior F5 Engineer with a proven track record in enterprise-scale application delivery, load balancing, and secure traffic management. This role requires deep expertise in F5 BIG-IP LTM, iRules...

Perform Dental daily review/audits on client data for completeness and accuracy of coding, utilizing coding background to ensure appropriateness for reimbursement when providing recommendations on clinical claims to the client:  Makes certain the requirements for Current Dental Terminology (CDT), ADA and other related concessions are met. Performs duties according to structured algorithms or other written guidelines. Handles moderately complex issues, refers all medical necessity procedures to higher-level staff for approval or denial. Possesses solid working knowledge of subject matter. High school...

The Integration Business Analyst will play a key role in supporting the successful development and implementation of integrated health enablement technology solutions. This position will be responsible for requirements gathering, cross-team coordination, and ensuring seamless integration between multiple technology platforms and services. Together with the project lead and multiple workstream teams, you will be responsible for ensuring a smooth design, build and implement process for our risk adjustment solution initiatives.

Cotiviti is a leading solutions and analytics company that leverages financial datasets to deliver deep insight into the performance of retail system. These insights uncover new opportunities for retail organizations to collaborate to improve their financial performance and accuracy along with reducing inefficiencies.   The Principal Software Engineer is primarily responsible for the design, development and support of the existing software applications and...

The Generative AI Research Engineer Intern conducts primary and secondary research of advanced and emerging healthcare informatics technology with a focus on Generative AI and emerging Artificial General Intelligence technology for healthcare treatment, payment, and operations use cases. Creates research papers, analytical reports, proposals, and educational material. Maintains a deep understanding of technology trends and hands-on experience with relevant technologies. Develops generative AI models, architectures, databases, and systems to improve healthcare solutions.   We are currently looking for interns...

The Product Director will drive strategy for Cotiviti’s Payment Integrity Client platform product roadmap. This individual will have responsibility and leadership for understanding and prioritizing market needs, performing competitive analysis, performing product discovery, supporting design, delivering business cases and leading delivery and commercial product launches for new products and capabilities

Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our team as a Product Manager.   This is a key role within that is...

Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our healthcare recovery team as a Senior Payment Accuracy Specialist.   

Cotiviti Healthcare is a leader in payment accuracy services, serving top-tier companies in healthcare and retail. We're actively seeking exceptional tech talents who are passionate about driving innovation, transforming healthcare systems, and accelerating their professional growth. Join our dynamic team of problem solvers and make a meaningful impact in healthcare payment integrity as a Principal Insights Analyst. This role is a key contributor to  healthcare team, playing a crucial role in supporting the Payment Integrity area, and will partner closely with other business...

Cotiviti, Inc. drives better healthcare outcomes through data analytics. This means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality.   Learn more at www.Cotiviti.com.

As a Senior Database Admin, you will help drive team(s) in meeting project objectives. You are expected to contribute to and foster high performing technical teams. You will also be responsible for the design and coding of complex DB systems. You will collaborate and communicate effectively with architects, engineers, QA, DBAs, and Business managers to solve complex problems spanning their respective areas and resolving technological disagreements with informed, rational debate. You will...

The Senior Solution Architect is responsible for creating best-in-class business offerings. This is accomplished through collaboration with business leaders, sales and support teams, and client conversations. The Senior Solution Architect will have responsibility for establishing and sustaining processes and practices that support present and future sales and implementations, ensuring sales are aligned with current technical offering and capabilities, and that custom client requests are substantiated and well understood. The Senior Solution Architect should have a passion for helping others understand our technical solutions and architecture, creating well defined...

The focus of the VP, Senior Client Engagement Lead is to develop and execute against broad relationship, growth, renewal and retention strategies on their customers within the top customer tier. The VP, Senior Client Engagement Lead is accountable for the coordination and transparency needed to drive a successful, multi-pronged growth and retention strategy as well as a multi-level relationship engagement across the customer leadership team. The VP, Senior Client Engagement Lead is accountable for cross-product strategy coordination as well as development and execution against a broad relationship map to drive deep...

The focus of the VP, Senior Client Engagement Lead is to develop and execute against broad relationship, growth, renewal and retention strategies on their customers within the top customer tier. The VP, Senior Client Engagement Lead is accountable for the coordination and transparency needed to drive a successful, multi-pronged growth and retention strategy as well as a multi-level relationship engagement across the customer leadership team. The VP, Senior Client Engagement Lead is accountable for cross-product strategy coordination as well as development and execution against a broad relationship map to drive deep...

Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our team as Platform Product Manager.  

The Director of Competitive and Market Intelligence will lead the research and analysis of Cotiviti's competitors, their products, strategies, strengths, weaknesses, opportunities, and threats. The Director of Competitive and Market Intelligence will also lead programs to monitor and report on micro and macro healthcare trends and coordinate with industry analysts, especially those related to payment integrity, quality and performance, risk adjustment, and consumer engagement. This role will provide actionable insights and recommendations to Cotiviti's senior

The Records Processing Agent processes incoming and outgoing mail containing medical records and requests for records as well as document reproduction while maintaining production and quality levels through tracked metrics. This is an ONSITE POSITION at our South Jordan, Utah location. This is a TEMPORARY POSITION for 6 months. 

As a Senior Systems Engineer you will be responsible for resolving escalated service issues, coaching other engineers to resolutions, engineering and implementing complex projects, and for maintaining and overseeing the technology of their assigned areas. This includes VMWare, Windows, and Linux environments.  

As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role.   This role aligns with our pre-pay Fraud Waste & Abuse team. 

This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on the following disciplines from a coding and billing perspective: Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the appropriateness of treatment setting and services delivered.

Join a recently formed team focused on Model Risk and Responsible AI. The Generative AI Scientist - Risk will apply knowledge and experience to real world problems and seek to utilize their skills to reduce the cost of healthcare and improve health quality and outcomes. As a Data Scientist on this team, you will focus on three main project areas: Model Validation, Model Metrics and Monitoring, and Responsible AI. This requires someone with depth in

The HR Business Partner will be a member of a business unit and or functional leadership team and serve as a key business partner to provide strategic and tactical human resources leadership. This role will partner with other HR processes such as talent acquisition, performance management, compensation, organizational effectiveness and benefits.  The HR Business Partner will be involved in employee coaching and development, employee communication; lead innovative HR programs and practices to drive employee satisfaction and retention; partner with management to provide strategic support and leadership, develop successful leaders and build effective teams for the organization; and support broad based...