The Medical Director focused on Implementation & Sales is a key member of the Go To Market team. The role is to serve as a coding and medical payment policy subject matter expert (SME). This position is responsible for supporting the sales process for our Payment Policy Management and Clinical Validation lines of business, reviewing and presenting results of the Opportunity Analysis supporting sales, and presenting policy/directing the client toward appropriate policy adoption during the implementation phase. The Medical Director will then transition the client to a Client Medical Director after approximately 30 days post...
The Client Services Manager is responsible for leading the cross-functional client team and providing the highest level of service to our clients. The role serves as both internal and external client liaison, including triaging, managing, monitoring, and support of a client-related activity, primarily related to Cotiviti Prospective Claims Accuracy products.
A Senior Revenue Cycle Specialist is a member of the Revenue Cycle team within the Yield Management Division. This department may work directly with other members of Yield to ensure department expectations are accomplished. The Sr. Specialist, Revenue Cycle position is responsible for complex levels of recurring and/or daily functions and processes that are necessary for business execution; including but not limited to, ensuring the quality of various functions within the department (check application, offsets, invoicing,...
A Payment Accuracy, Coordination of Benefits (COB) Specialist 1, 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.
The Payment Accuracy, Coordination of Benefits (COB) Specialist 1 position is responsible for reviewing and analyzing the multi-client impact, complex member selection, and query or filter construction of data to identify instances of recoverable...
A Payment Accuracy, Coordination of Benefits (COB) 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. Our specialists are passionate about what they do and are experts at reviewing, discovering, and validating substantial amounts of data and delivering results and insights for our clients.
A Payment Accuracy, COB Specialist, is responsible for reviewing and analyzing claims, member, and group data to identify instances of recoverable claims for the benefit of Cotiviti...
The Data Solutions Architect provides architectural leadership and guidance in their assigned business area, aligning solution development efforts with the broader architectural vision and roadmap. A Technical Architect’s skills and knowledge must include multiple domains (Application/Solution architecture, Technical/Infrastructure architecture, Information/Data architecture), and experience with relevant implementation technology, platforms, and tools. As a leader, a Technical Architect is expected to influence the assigned organization and work independently with senior business and IT leaders, while acting as a mentor and role model within the development teams. The Technical Architect is...
A Payment Accuracy, Coordination of Benefits (COB) Manager, 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 COB Manager role are passionate about leading a team to accomplish the identified goals for the success of the team, Cotiviti, and client partnerships.
The Payment Accuracy, Coordination of Benefits (COB) Manager position is responsible for leading a team...
The staff accountant reports to the Director of Accounting and is responsible for preparing journal entries, account reconciliations and other activities associated with the monthly general ledger close and preparing balance sheet and income statement variance analysis.
The Client Policy Manager provides expert consultation on coding & clinical policy guidelines . This role works directly with our health plan clients and manages our clients payment policies and ensures they are accurate, up-to-date, and complete. This role is responsible for interpreting and assessing payment policy for clients and provides consultation and policy advice. This role works with a team of others: Medical Director, Client Managers, and Financial professional to deliver and implement clinical & coding guideline changes to their assigned clients.
The Data Scientist II - 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, auditors and innovators to...
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...
The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. This role works with the Director of Coding, the Client team and other areas related to production, QA, and analytics for oversight of ongoing production and quality accuracy.
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 preparing and submitting check request to corporate finance, processing electronic requests in multiple systems and platforms, and preparing and submitting spreadsheets to our clients.
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 Manager on our Payment Accuracy team.
The...
The Billing Specialist is responsible for overseeing the billing process in their specific areas for our Cotiviti clients.Their duties include processing invoicing and supporting reporting, maintaining organized financial records, collaborating with other departments, and resolving client questions and issues relating to invoices.
The QA I, Clinical Ops position works with the Coding & Clinical Validation Audit team focused on risk coding. The QA position monitors & reports on the accuracy of all code captures on a % of all images of their assigned coders. This position also answers all questions for their coders through the Questions Queue or via email. QA is also responsible for assisting in the remediation for their coders which include full image review of all images coded prior to release to ensure accuracy of image, for any coder below project benchmark.
We are currently looking for multiple Remote Risk Adjustment / HCC Coders for full-time...
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 healthcare landscape is rapidly changing. The Associate Software Engineer will work to deliver on projects. This
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 Software Engineer is responsible for the design and development of software applications and reusable software components for the Cotiviti Inc...
This is an onsite position at our Blue Bell, PA office.
In the End User Computing Analyst role, you will provide support for internal employees for all IT services. You will also process incoming technical support incidents and requests through the ServiceNow & JIRA ticket queue while maintaining service level agreements.
The Sr. Software Engineer is primarily responsible for the design and development of software applications and reusable software components deployed in the Cotiviti product suite. You are expected to foster high performing technical teams. You will be required to collaborate effectively with senior developers, offshore development team members, business owners, project management, and other internal stakeholders.
This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on one of the following disciplines from a coding and billing perspective: SNF, IRF, Home Health, APC, ER, Diagnostics and Professional Service. This position is responsible for auditing outpatient/specialty claims and documenting the results of those audits. with a focus on clinical review, coding accuracy, medical necessity, and the appropriateness of treatment setting, and services delivered.
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 Manager on our Payment Accuracy team.
Cotiviti drives better healthcare outcomes through data analytics. Our payment accuracy, revenue integrity, risk assessment and stratification, and quality improvement solutions help organizations utilize their data so they can efficiently and cost-effectively succeed in the new era of healthcare.
We are currently looking for multiple Remote Risk Adjustment / HCC Coders (Coder 1) for full-time permanent positions.
See what it's like to work as a Coder at Cotiviti:
Cotiviti drives better healthcare outcomes through data analytics. Our payment accuracy, revenue integrity, risk assessment and stratification, and quality improvement solutions help organizations utilize their data so they can efficiently and cost-effectively succeed in the new era of healthcare.
We are currently looking for multiple Remote Risk Adjustment / HCC Coders (Coder 2) for full-time permanent positions.
See what it's like to work as a Coder at Cotiviti:
The Client Retention Director is a role within the Go-To-Market team dedicated to partnering with Cotiviti’s internal Sales, Client Engagement, and the /business unit to successfully renew strategic or named clients with favorable terms and conditions.
The Client Retention Director is responsible for independently leading assigned deals and working as a member of a collaborative team. The role will be responsible for proactive management of the renewal schedule for assigned clients working with the business units, Legal, and Finance. This role will prepare internal renewal strategy materials, facilitate client-ready...
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.
In partnership with client-facing teams, the Client Enablement Manager serves as an intermediary between clients and development, with a focus on client-centric project management, troubleshooting and escalation. This role will also
The Business Intelligence Developer collaborates with various team members and operational departments to develop internal and external reporting tools and gather/analyze requirements using industry best practices. They will work extensively in both ad-hoc and standard reporting packages and be involved in creating reports and dashboards that are scalable with large volumes of data.
The QA I, Clinical Ops position works with the Coding & Clinical Validation Audit team focused on risk coding. The QA position monitors & reports on the accuracy of all code captures on a % of all images of their assigned coders. This position also answers all questions for their coders through the Questions Queue or via email. QA is also responsible for assisting in the remediation for their coders which include full image review of all images coded prior to release to ensure accuracy of image, for any coder below project benchmark.
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 Senior Software Developer will work with core applications and database in the Payment Policy Management platform to help build and deliver features as a part of the team using SAFe practices. The...
The Policy Quality Auditor I role is responsible for ensuring the accuracy of new policies and current policies for existing healthcare clients. This role serves as the final checkpoint in validating the accuracy of developed and processed work orders created and configured for rules.
The Data Integration Specialist will analyze, develop and enhance all new and existing interfaces for claim batch file and real-time data integration. The person in this role will serve as a subject matter expert for healthcare claims analysis utilizing both technical expertise and business insight. This role provides analytical support to internal and external customers on various projects, conducts detailed claims analysis and ad-hoc reporting as prioritized by management. This person in this role will spend time working independently, as part of a broader team, and will focus on...
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 preparing and submitting check request to corporate finance, processing electronic requests in multiple systems and platforms, and preparing and submitting spreadsheets to our clients.
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.
The Information Security Analyst will support the Sr. Manager of Security Audit in developing, implementing, and monitoring a comprehensive information security audit program. This program includes HITRUST, SOC 2, and other relevant security assessments. The ideal candidate will have 3-5 years of IT audit experience, with specific experience in HITRUST and SOC 2, preferably within the health industry.
The Sr. DevOps Engineer role provides support for R&D initiatives. The role is primarily responsible for the availability and reliability of the infrastructure and business services within R&D group: Hadoop (Cloudera) ecosphere, as well as Kubernetes/OpenShift and ML/AI environments - on-prem and in the cloud. Heavy experience with variety of open-source technologies, as well as DevOps experience.
The Senior Workforce Capacity Analyst plans, develops, and implements operational workforce models and contingency plans to ensure coding resources are appropriately allocated to ensure project timelines and deliverables are met. This role monitors the day-to-day project progress against production plans and interacts with team(s) of coders, directly or indirectly to deliver key components to the Cotiviti coding program. This role works with all levels of coding leadership, as well as External Vendor Management and other areas related to coding production, quality, training, and analytics to ensure desired production outcomes are achieved.
Strategic Vendor Solutions ("SVS") provides support services to the entire Cotiviti, Inc. ("Cotiviti") organization for the contracting of vendors who provide products and services to Cotiviti as well as any vendors with potential to join Cotiviti's mission through a joint venture, product development or some other form of strategic partnership.
Cotiviti is a leader in analytics driven healthcare payment accuracy and quality-based solutions with locations in the USA, Canada, Australia, Nepal and India and relies heavily on leading edge technology to deliver these products and services to our wide range of customers. SVS is tasked with...
Cotiviti is looking for an enthusiastic and dedicated Client Executive (CE) who is motivated to support the transformation and improvement of our nation’s healthcare system through the use of healthcare analytics and consumer engagement.
The CE role is a critical, client-advocate position with both internal- and external-facing responsibilities. The CE is assigned ownership of an existing set of accounts and is responsible for understanding how the client is using our solutions and helping them maximize the potential of our tools....
The VP, Product Development will lead a matrixed team to prioritize and deliver new solutions to the market. This role will define and lead Cotiviti’s strategy to deliver new payment integrity solutions leveraging our leading industry position and expertise to focus. This individual will have responsibility for leading a team and personally understanding and prioritizing market needs, performing competitive analysis, engaging experts within and outside our organization, defining solutions for new market needs, and leading delivery and product launches for new offerings.
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 developers, offshore development team members,...
The Senior Software Engineer - Full Stackwill work with core applications and database in the Payment Policy Management platform to help build and deliver features as a part of the team using SAFe practices. The developer will need to have strong healthcare background and be familiar with the domain. The developer will be focusing on one or more specific initiatives with the team. The developer will be responsible for implementing features for upcoming new initiatives while also making recommendations and improving the existing code base.
The developer...
We're looking for an Auditor 1 to join our Retail audit team. Cotiviti Retail audits purchases and payments related to merchandise inventories. We develop and prioritize an audit program to ensure value negotiated is value delivered, recommending actionable process improvements that help our clients improve the way they do business and mitigate financial loss from overpayments and under-deductions.
The primary focus of a Systems Engineer within IT Operations is to participate in projects that support technology growth and innovation. Systems Engineers also provide advanced technical support for all IT systems including server platforms, storage, and other cross-functional capabilities. They develop and implement new solutions, improve existing solutions, and provide a path of escalation for complex or high-risk IT requests.
The focus of the VP, Client Engagement is to develop and execute against growth, renewal and retention strategies on their customers within the top customer tier. The VP Client Engagement 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.
We are seeking a highly skilled and experienced developer to join our dynamic team. The developer will be responsible for designing, developing, and maintaining software applications using various programming languages and technologies. The ideal candidate must have a strong background in Power Apps, Power Automate, AI Builder, and Azure AI Studio, as well as proficiency in languages such as Python, C# sharp, .NET, Blazor, JSON, etc.
The purpose of the BI Developer role is to design, develop, and implement business intelligence solutions that empower our organization to make data-driven decisions. The BI Developer will be responsible for creating and managing data-driven solutions that provide actionable insights, improve operational efficiency, and drive strategic decision-making. This role is critical in helping the organization leverage data to gain a competitive advantage and achieve business objectives.
This position is eligible to be REMOTE but must live in the Mexico City/Mexico...
We are in search of a DevOps Engineer with a specialization in Azure AI Studio, Azure Open AI, Microsoft Copilots, AI and ML methodologies, and AWS Bedrock. In this role, you will be the guiding force behind our AI initiatives, providing expertise and leadership to all users across the organization who have AI use cases. Your focus will be on architecting, developing, and implementing advanced AI solutions while ensuring alignment with best practices and business objectives.
Cotiviti Retail audits purchases and payments related to merchandise inventories. We develop and prioritize an audit program to ensure value negotiated is value delivered, recommending actionable process improvements that help our clients improve the way they do business and mitigate financial loss from overpayments and under-deductions.
Too often, audits, contract reviews, and recovery efforts focus on one aspect of a retailer’s operations without considering how the business works as a whole. Cotiviti Retail works smarter and digs deeper, looking at a business from all angles to find sources of profit in unexpected places....
This is a technical role within Cotiviti’s IT Organization for a Jira and Confluence Architect. The ideal candidate will have a proven track record in designing, implementing, and managing Jira and Confluence Data Center products to meet complex business requirements. This role requires strong architectural expertise, hands-on experience, and the ability to optimize Atlassian products and secure Jira and Confluence environments.