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We are looking for a Revenue Cycle Specialist to join our Yield Management team! This role is responsible for the reconciliation and posting of all payments received, identify discrepancies and analyze issues to ensure all payments are posted timely. Other responsibilities include managing inventory and system alignment between Cotiviti and our clients, reconciling data between different sources, research, and the ability to work with cross-functional teams.
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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 Blue Bell, PA location. This is a TEMPORARY POSITION for 4 months.
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We are seeking a highly accomplished Principal AI Process Specialist to lead enterprise-critical process improvement initiatives that drive strategic growth and operational transformation. Looking for a senior leader with a proven track record of delivering significant process improvements with financial impact of seven to eight figures.
The Principal AI Process Specialist will lead cross-functional digital transformation and process...
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The Business Operations group works in small project teams to identify and address complex business challenges. The team operates like an internal consulting group to define and drive strategic, operational, and organizational improvements across the business.
Successful candidates will be self-motivated, intellectually curious, a fast learner, comfortable with ambiguity and working independently, able to focus on details while thinking strategically. They will have the ability to solve business problems of moderate to complex scope and deliver insights that enable timely and effective operational...
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We are seeking an experienced Manager, Engineering- AI to lead our data engineering team. This individual will play a crucial role in overseeing the development of strategic perspectives regarding IT architecture and business needs. The Manager of Engineering will develop and implement data architecture and engineering strategies leveraging innovations in AI while exemplifying strong software development experience when working in an Agile environment. This individual will provide guidance to employees in accordance with established policies and management directives.
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This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have a coding/auditing background focused on Inpatient DRG Coding from a coding and billing perspective. This position is responsible for auditing inpatient DRG and documenting the results of those audits with a focus on coding accuracy and the appropriateness of treatment setting and services delivered.
This role...
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Develops, configures, tests, modifies, and supports software applications and integrations using AI-enabled development tools, Microsoft .NET, SQL Server, MySQL, Oracle, and related technologies. Works within established architectures, design specifications, development standards, and change-control procedures to support back-office ERP and finance systems. Collaborates with more experienced developers, IT support teams, and business partners to clarify requirements,...
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Join a recently formed team focused on Model Risk and Responsible AI. The Senior GenAI Scientist II – 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
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The Sr. Revenue Integrity Analyst owns advanced revenue analysis and key month-end controls that support accurate invoicing, revenue application, inventory reconciliation, revenue cycle processes, and financial reporting within the complex chart review business function. This role investigates revenue leakage, applies revenue, manages revenue SLAs, analyzes inventory and financial variances, and leads resolution of invoice and client issues. The role develops actionable reporting, partners across functions to correct root causes, and mentors junior analysts.
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The Sr. Revenue Integrity Analyst owns advanced revenue analysis and key month-end controls that support accurate invoicing, revenue application, inventory reconciliation, revenue cycle processes, and financial reporting within the complex chart review business function. This role investigates revenue leakage, applies revenue, manages revenue SLAs, analyzes inventory and financial variances, and leads resolution of invoice and client issues. The role develops actionable reporting, partners across functions to correct root causes, and mentors junior analysts.
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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
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Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.
The Sr Software Engineer is primarily responsible for the support of the existing software applications and enhance software components deployed in the Cotiviti product suite. The successful candidate will be required to collaborate effectively with senior...
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The Coder I is responsible for conducting accurate, compliant, and complete diagnosis code abstraction for Medicare, Commercial, and Medicaid risk‑adjustment programs across a variety of chart types. This role applies ICD‑10‑CM Official Guidelines, AHA Coding Clinic guidance, and Cotiviti/client‑specific requirements to ensure high‑quality coding outcomes. The Coder I utilizes established dispute‑resolution processes when coding disagreements arise and communicates professionally with team leadership regarding findings, errors, and improvement opportunities.
We are currently looking for multiple Remote Risk...
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The Marketing Business Operations Specialist supports the Corporate Affairs organization by helping maintain the operational infrastructure that keeps the marketing function organized, efficient, and scalable. This role supports vendor and technology inventory, contract and SOW tracking, renewal coordination, procurement and invoice support, license and utilization tracking, vendor performance monitoring, SharePoint administration, process documentation, and cross-functional operational requests. This is a growth-oriented opportunity for a highly organized, detail-oriented individual to learn the marketing function, build business operations expertise, and develop a career path within Marketing Operations, Business Operations,...
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The Subrogation Recovery Specialist is responsible for analyzing and recovering dollars related to an accident, injury, or illness in which another party is responsible. The Subrogation Recovery Specialist must work with attorneys, other health carriers, adjustors and more to both accelerate and maximize settlement amounts which will lead to savings for our clients. This position requires a combination of both oral and written communication skills combined with the ability to proficiently review healthcare claims and case documentation to deliver value and maintain a high standard of quality.
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The Implementation Manager is accountable for the operational execution of the project plan for new customers or new projects specific to existing customers. They will partner with the client services organization to meet client expectations and revenue goals, as well as with any/all internal departments in support of the plan execution to include IT, product, product development, operations, finance, and training. They will define and lead the creation of project implementation project plans, identify process improvement opportunities,
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Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.
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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...
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This role is part of the training team for the Clinical Chart Validation team. This position is responsible for improving the technical effectiveness of our teams by planning, developing, and delivering technical training, mentoring, and assessment. The individual will work collaboratively with subject matter experts in the Commercial & Government Audit Teams, Quality Assurance, Concept Development, and others to validate workflows and communication tools to enhance audit productivity, performance, and client satisfaction.
This work is focused on Training for our Outpatient & Specialty Clinical & Coding Validation...
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The Principal IAM/PAM Security Architect defines and evolves security architecture for identity and privileged access across a large, complex, multi-domain environment spanning Active Directory, Microsoft Entra ID, and Okta, as well as cloud-native identities across AWS, Azure, GCP, and OCI.
This role sets security standards for each identity environment, leads the definition of emerging Agentic Identity standards for AI agents and other non-human identities, defines requirements for and drives implementation of the Delinea PAM platform, and owns secrets governance...
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The Artificial Intelligence Governance, Director provides enterprise-wide oversight, coordination, and visibility for Cotiviti’s AI governance framework, ensuring consistent documentation, responsible AI use, regulatory readiness, and ongoing post deployment compliance monitoring across all business units.
The position operates with significant autonomy at the Enterprise level to develop and oversee enterprise AI governance standards, compliance reporting mechanisms, and evidence collection processes, while ensuring business units retain ownership, accountability, and responsibility for...
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Provide technical and operational support to enterprise customers by resolving product-related issues and delivering high-quality customer experience. Mentor Product Support and Product Operations teams, collaborate with Implementation and Development teams, and support release activities through testing, validation, performance analysis. Collect, analyze, and document critical information required for accurate problem diagnosis and resolution.
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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...
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The Vice President, Engineering is a senior leadership role within the Engineering organization, responsible for defining and executing the product engineering strategy and leading the development and delivery of high-quality, scalable software products.
This role oversees a global engineering organization and partners closely with Product Management, Design, and Go-to-Market teams to build innovative, customer-centric solutions that drive business growth and market differentiation. The VP is accountable for delivering impactful product outcomes, accelerating time-to-market, and ensuring engineering excellence across the product lifecycle.
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The Sr. Support Engineer is primarily responsible for the support of the existing software applications and enhance software components deployed in the Cotiviti product suite. The successful candidate will be required to collaborate effectively with other developers, offshore development team members, business owners, project management, and other internal stakeholders.
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The Senior Support Analyst will assist in monitoring, analyzing and resolving data platforms, configuration, and infrastructure related issues. This person serves as a liaison between technical and operation teams. This position provides analysis and problem solving, technical assistance and support coordination to business stakeholders. The person will make decisions based on independent judgement to resolve a range of complete technical problems. The Senior Support Analyst needs strong analytical skills and the ability to think outside the box when the root cause...
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The Senior Support Analyst will assist in monitoring, analyzing and resolving data platforms, configuration, and infrastructure related issues. This person serves as a liaison between technical and operation teams. This position provides analysis and problem solving, technical assistance and support coordination to business stakeholders. The person will make decisions based on independent judgement to resolve a range of complete technical problems. The Senior Support Analyst needs strong analytical skills and the ability to think outside the box when the root cause...
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The Senior Support Analyst will assist in monitoring, analyzing and resolving data platforms, configuration, and infrastructure related issues. This person serves as a liaison between technical and operation teams. This position provides analysis and problem solving, technical assistance and support coordination to business stakeholders. The person will make decisions based on independent judgement to resolve a range of complete technical problems. The Senior Support Analyst needs strong analytical skills and the ability to think outside the box when the root cause...
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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...
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A Revenue Cycle Specialist 2 is a member of the Revenue Cycle team within the Yield Management Division. The Specialist 2 is responsible for moderate to complex levels of recurring and/or daily functions and processes that are necessary for business execution. This would include the reconciliation and posting of all payments received, identification of discrepancies, and analyzed issues to ensure payments are posted timely. Other responsibilities will include processing invoices, managing large sets of inventories and the ability to process electronic requests in multiple systems and platforms.
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The Sr. Technical Product Owner (STPO) is responsible for driving solution definitions that support
business ideas and product concepts that can be turned into application software solutions. The STPO
works at a team, program, and enterprise level, gathering needs and translating those into testable
requirements.
The STPO has deep domain knowledge and strong experience in collaborating with a
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The Product Marketing Director owns go-to-market strategy and execution for an assigned solution area within Cotiviti's portfolio. This particular individual contributor role will support our Quality, HEDIS and Stars solutions by working directly with our Product, Operations and Sales/Client Engagement teams.
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As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients.
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The Clinical Consultant support Clinical Services teams in the validation of quality and processes consistency on the CPE editing engine.
Provides support and subject matter expertise on Coding Validation (CV) to both clients and internal stakeholders during the planning, implementation, go-live, transition to operational team, and through the duration of the contract. Clearly understands and articulates CV concepts and policies. Collaborates with internal teams to provide meaningful input on CV...
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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.
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Cotiviti is consolidating several client-facing portals into one unified Client Performance Portal — spanning executive, analyst, and operations views, and covering SLA reporting, benchmarking, case detail, enhancement requests, roadmap visibility, regulatory insights, and billing self-service. One module already exists in production (Support/ticketing, built on Blazor/.NET, Azure PaaS, Okta, and Jira) and will be folded in rather than rebuilt from scratch.
We're...
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As a member of the Corporate legal team, you will provide exceptional legal services to internal business units by responding to routine matters and questions in a timely manner. You will also review, draft and negotiate various contracts, but not limited to business associate agreements and statements of work. Additional responsibilities include contracts library research, administration, review of regulatory agreements and answering inquiries on RFPs.
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The Enterprise Marketing Director executes marketing initiatives that support Cotiviti's established enterprise narrative and brand positioning under guidance from marketing leadership - work that spans every portfolio rather than belonging to one. This role supports development and deployment of enterprise messaging assets and campaign materials aligned with approved messaging frameworks, supports Cotiviti presenters in analyst relationships and executive briefings, and synthesizes competitive and market signal into the corporate story. Unlike a portfolio-aligned Director Product Marketing role, this position has no assigned solution area: its scope is the company's story as a whole.
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The Product Manager (within Payment Accuracy Product Suite) will be responsible for product management and development supporting Cotiviti payment integrity prospective products Payment Policy Management (PPM) and Coding Validation (CV). This role is dedicated to creating and optimizing products that enhance and expand the Cotiviti payment integrity services for our clients. This role will serve as a product subject matter expert working closely with stakeholders to drive product requirements, design, and successful delivery.
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The Content Solutions Analyst I is a key member of the clinical operations and content team responsible for the research, quality assurance, and opportunity analysis associated with new medical policies. In addition, this position will be responsible for review and analysis of current medical policies and assisting in the research necessary to define additional logic and algorithms to expand the Cotiviti payment policy library.
The Content Solutions team works within Payment Policy Management and supports all of our PPM Solutions: outpatient, inpatient,...
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As a Data Solution Specialist at Cotiviti, you will play a pivotal role in designing, executing, and optimizing data transformation processes that drive our strategic business objectives. Your focus will be on hands-on development and integration of healthcare data, collaborating with stakeholders to translate business requirements, acceptance criteria, and non-functional requirements into actionable data solutions.
You will leverage your technical expertise to ensure the seamless processing and integration of large healthcare datasets. Using advanced tools such as the Hadoop ecosystem (including Hue...
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This role provides senior-level technical engineering and troubleshooting support for enterprise clients running hybrid environments that span legacy Windows and Linux systems and Kubernetes-based infrastructure. Responsibilities center on root-cause analysis of complex, multi-tier defects - reproducing issues in controlled environments, engineering fixes, and validating them through automated test suites.
The role also carries direct ownership of delivery infrastructure: building and maintaining CI/CD pipelines (Jenkins, GitLab CI, or Azure DevOps),...
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The Data Governance & Analytics Architecture Director is a leader within the Health Enablement Analytics organization responsible for ensuring all data, analytics, and AI initiatives are built on a scalable, standardized, and governed foundation. This role serves as a subject matter expert for data governance, analytics architecture, and AI/ML best practices across Health Enablement. This role provides advisory leadership, technical guidance, and architecture standards to ensure analytics and innovation efforts are aligned to enterprise data strategy and built in a scalable, sustainable manner.
This position operates as a...
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The Client Policy Manager I manages client payment policies by ensuring client’s payment policy is accurate, up-to-date, and complete; executes client-specific requests with guidance from internal team and acts as the internal and external client team liaison.
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A Lead Solution Consultant will play a pivotal role in driving Cotiviti’s growth by combining deep technical expertise with strong pre-sales acumen across the healthcare payer landscape. This is a client-facing role requiring the ability to lead technical discovery, perform detailed assessments, and design solution architectures aligned to payer business and IT environments.
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The Senior Technical Specialist will collaborate closely with the RCA - Content & Enablement Department, the Implementations Team, and the Audit Operations and R&D teams. This role is responsible for the intake, logic development, deployment, and maintenance of Business Rules that support RCA’s platform applications. The Specialist will also lead efforts to identify and remediate technical limitations, design advanced exclusions logic, and support operational scalability through strategic rule development.
In addition to driving rule implementation, the Senior Technical Specialist will act as a key liaison between the operations team and the BRMS...
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We are seeking a highly experienced Principal AI Engineer to lead the architecture, design, and development of a cutting-edge agentic framework and centralized AI platform that serves as the foundation for the organization's AI initiatives. As the technical lead for the Risk Adjustment (RA) Coding Agent, you will own the end-to-end technical architecture—from clinical NLP integration and production routing to core AI platform components that enable...
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Cotiviti is a leading healthcare analytics solutions company seeking an experienced BI Developer III to join our analytics and business intelligence team. In this role, you will design, develop, and maintain enterprise data warehouse solutions that leverage deep healthcare datasets to drive insight into healthcare system performance. You will translate complex stakeholder requirements into technical implementations while working with cross-functional teams using Safe Agile methodologies to deliver high-quality business intelligence solutions that reshape the economics of healthcare.
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The Client Services Manager services as the point of contact for clients and is focused on providing the highest level of service to our clients. Role serves as both internal and external client liaison, including triaging, managing, monitoring and support of client related activity, primarily related to Cotiviti Fraud, Waste and Abuse products.
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We are a Healthcare Data Analytics company looking for Senior Director, Software Engineering within our Payment business. In this role you will lead, direct, and manage the cross-functional technology delivery team. You will manage all the operational aspects of the software development to ensure business and project objectives are met. You will provide technical, administrative, and people leadership for multiple, diverse, and geographically distributed teams.
You will champion an AI-native approach to software delivery by integrating AI tools, automation, and intelligent engineering workflows across the software...