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.  

The Director of Solution Innovation Development will lead early research and development of new solutions for healthcare technology. The Director will hire, train, and lead a cross-functional team of BizOps, DataOps, AIOps, DevSecOps, & CloudOps engineers, and must be able to lead traditional full-stack solution development as well as AI development, and experimental vibe-coding and virtual agentic teams. The director will be tasked with building virtual

The Sr. Technical Product Owner (STPO) is responsible for driving solution definitions that support business ideas and product concepts at a team, program, and enterprise level through gathering and translating testable requirements into application software solutions. The STPO 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. STPO has the ability to quickly learn and develop new products and support integration efforts across multiple products and release trains.

We are seeking a skilled and proactive Strategic Sourcing Specialist to join our strategic sourcing team. The ideal candidate will have a background in sourcing, supplier management, or purchasing. This role requires an analytical thinker with the drive for continuous improvement in our sourcing processes.

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 Quality Engineer performs software testing on Retrospective internal & external applications to ensure product quality, usability and integrity.

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...

The Business Analyst is responsible for helping to develop solutions that support business ideas and product concepts through gathering and translating testable requirements into application software solutions. To be successful, the Business Analyst is required to work independently and collaborate with a diverse agile team including product managers, software developers, testers, and teams such as Client Services, Operations, and File Processing.

The Immigration Counsel will serve as in-house immigration legal advisor to Cotiviti. They will be responsible for partnering with leadership on company immigration operations in compliance with federal and state laws and administrative policies. This person will act as the extensive knowledge on all immigration related activities including, but not limited to, visa caseloads, immigration law, immigration document retention, communications with employees, etc. The Immigration Counsel will draft key documents, assist in the completion and filing of all immigration related paperwork, present clear recommendations, and assure legal compliance. They will handle the preparation of immigration...

At Cotiviti, we are custodians of clinical data for our clients, which requires effective data connectivity and security. The Interoperability Solutions Architect function uses a standards-based methodology to create connections between Cotiviti and clinical data sources such as electronic medical records, health information exchanges, national networks, and vendor partners. The Interoperability Solutions Architect will be responsible for data connectivity and ingestion. In this role, you will facilitate discussions...

The Intern - Technology Research Assistant/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.

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...

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...

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.  

The Team Lead is a member of the Revenue Cycle team within the Yield Management area of Cotiviti. This department will work directly with other members of Yield to ensure department expectations are accomplished.   This role is responsible for training, leading and daily oversight of Revenue Cycle Specialists, Specialist 2 and Seniors, as well as the knowledge share and refinement of Revenue Cycle

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,...

The Senior Project Manager is tasked with driving large, cross-discipline, company-wide projects with high executive visibility. These projects include post-merger integrations, international operations, systems implementations, and other projects as directed. As each project is different, the project manager must use a variety of tools, approaches, and formal methodologies to successfully complete the objectives. This position is strongly self-driven, with the project manager given an end goal and responsible for independently driving the project to success, while interacting with a large variety of independent teams and separate disciplines. Projects can involve simultaneous coordination...

The Senior Technical Specialist from Coordination of Benefits (COB) will be responsible for working with product owners and technical architects to define project scope, technical direction, and project milestones. You will have responsibility for working with other stakeholders to define business requirements, acceptance criteria and non-functional requirements consistent with SAFe (Scaled Agile Framework). You will also handle tracking of project 

Manager of Clinical Content is a key member of the Content Center of Excellence, responsible for managing a team of nurses, medical coders and analysts that create and maintain policies in the Cotiviti payment policy library. This position works collaboratively with the global and onshore Medicaid teams as well as other payment policy teams (e.g., configuration, eLL, client team). The manager role is a hands-on position working diligently with team members to meet goals and deadlines. This includes an active role in the policy development process by interpreting company and regulatory guidelines, performing quality audits, and claims data analysis at multiple levels. The manager is similarly involved in post policy implementation...

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 PPM polices and rules. This is a full-time role and can work remotely in the US. 

The ideal candidate for the Senior Technical Product Owner (TPO) acts as a crucial link between product management, stakeholders, and agile development teams, ensuring that the technical implementation of a product aligns with the overall business vision and strategy. They are responsible for guiding product development, managing technical aspects, and ensuring product features meet both user needs and technical feasibility requirements. A 

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 team as an Operations Manager.   This role is aligned to our...

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 purpose of the Operations Manager role is to oversee the activities of the Retrieval Operations Center including projects, processes, and personal management. Daily, substantial contact with internal management and executives. Periodic contact with clients, providers, and business partners.

The Attorney, Vendor will support the Director, Senior Corporate Counsel in overseeing the full life cycle of Cotiviti’s healthcare and non-healthcare vendor contracts – from initial negotiation through execution, ongoing management, renewal, and termination. This role will be responsible for reviewing, drafting, and negotiating a broad range of commercial agreements, including master services agreements, license agreements, SaaS agreements, business associate agreements, non-disclosure agreements, and other related commercial agreements. The ideal candidate will have significant experience negotiating a wide range of commercial agreements – particularly in the areas of technology (SaaS agreements/software...

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.

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

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 Clinical Consultant support Clinical Services teams in the validation of quality and processes consistency on the Claims Processing Editing Engine (CPE).     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...

The CIR Manager works with subject matter experts (SMEs) across the enterprise to provide written responses to client information requests (CIRs) and questionnaires. The CIR Manager is responsible for managing the prioritization of CIR requests, negotiating due dates with submitters, escalating issues to senior leadership where appropriate, fostering cross functional communication, and coordinating cross-departmental responses to ensure timely and professional responses to CIR submitters. The CIR Manager reviews completed requests to ensure responses are reasonable, complete, professionally written, and...

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 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.   

At Cotiviti, the Director of Data Architecture and Management – AI will lead the Data Architecture and the Product teams within the AI team. This individual will be responsible for leading and establishing process, engineering patterns, product vision, standards and governance around all data assets within the AI Data platform.

The Stars Analyst works across the Cotiviti clientele to define, assign, and oversee best-in-class activities and Stars performance for all assigned Medicare Advantage plans. This individual is accountable for driving greater value and success for our customers by focusing on data, next best actions and maximizing member and provider outreach. They will also support identification of enhancements or improvements in the Cotiviti solutions to better support our clients.   The Stars Analyst will directly own and manage a small number of clients and is responsible to oversee all...

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)....

We are looking for a Software Development Manager to join our team. This role is responsible for designing a strategic perspective regarding IT architecture and business needs. You will also develop and implement architecture software strategy. Our ideal candidate with have strong software development experience working in an agile environment.

The Application Architect (App Arch) (Enterprise) implements and governs technical architecture development and provides architectural leadership and guidance to align IT solutions and development organization with the needs of the Enterprise. Will span multiple architecture domains (e.g., Application/solution architecture, Technical/Infrastructure architecture, Information/Data Architecture & Business Architecture) to ensure balanced solutions.  This App Architect role is specific to the IAM (Identity and Access Management) technology area, specifically OKTA, from a development perspective.  The Role will provide standards on Development interfaces using Industry Standards approaches such...

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.

The Sr AI Product Manager - We are seeking a passionate, talented, and enthusiastic individual to join the AI R&D team and help build industry-leading AI technologies, enabling lines of business with cutting edge and impactful solutions. You will lead the strategy, development, and lifecycle of data products that power GenAI solutions across the enterprise. This role bridges the gap between data engineering, AI teams, and business stakeholders to deliver high-impact, reusable data products.

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.     

The Sr Principal 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, auditors and...

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 Manager Data Solution role is aligned to our Implementation team and will partner will various divisions and levels of leadership within the whole organization.   They serve as a vital link between technical experts, business stakeholders, and leadership across the organization. This role is responsible for overseeing the management of requirements gathering, analysis, and development to support the implementation and ongoing maintenance of file layouts, data ingestion artifacts, data governance,...

The Implementation Services 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, coordinate and manage the client implementation effort with cross-functional groups, monitor complex operational reporting, and...

The Business Systems Analyst role is aligned to our Content and Enablement team within the Enterprise of Data Mining and Yield Management. This role will partner will various divisions and levels of leadership within the whole organization.   A Business Systems Analyst will work alongside Technical Specialists, Analysts, Content and Datameer Managers as well as external departments including any level of leadership to collaborate in achieving the goals established by the department and organization. Knowledge of product management, healthcare and experience as an Agile Product Owner will be critical for success of this role...

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.   

The Technical Specialist role is aligned to our Content and Enablement team focusing on Content Optimization. This role will partner will various divisions and levels of leadership within the whole organization.   A Technical Specialist is accountable to internal customers in the pursuit of implementing new and recurring projects. Manages milestone and task execution within assigned projects and internal process improvement efforts. Directly works with product managers and internal cross-functional...

Cotiviti is currently looking to add an industry leading Data Scientist I QA, who is focused on machine learning solutions to join our Enterprise Data Science Team and build value-oriented, production level machine learning solutions.    This role is not for research-oriented data scientist, but rather should be of interest to those that want to apply their knowledge and experience to real world healthcare problems and seek to utilize machine learning and artificial intelligence to reduce the cost of healthcare and improve the management of healthcare. With access to dedicated on premise and cloud based big data solutions, this role...

The Vice President, Product Success is a strategic new product launch leader and a member of the Enterprise Product Management team at Cotiviti. This person will play a key role in measuring and driving commercial success of our new product offerings, including understanding and removing barriers to sales and implementation success. In addition, they will be responsible for program and project managing product launch, design and large new product enhancements (from design approval to market general availability) and the championing of product best practices to enable profitable growth across the product portfolio. Reporting to the SVP of Enterprise Product, the Vice President will work in partnership with BU Leadership, Product...

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.

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.