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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,...
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The Part-Time Temporary Administrative Coordinator provides hands-on support with high-volume printing, document preparation, and outbound mailing. This role is ideal for someone who is detail-oriented, organized, and comfortable managing repetitive, time-sensitive tasks in an office environment,
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The Manager, Audit Content position is responsible for leading a team of Concept Development Analysts (CDA) and Operations Administrators in delivering value to Cotiviti’s operations and clients. This leader is responsible for oversight of their team, as well as participating in the development of new and existing complex audit concepts, executing audit projects, and updating concept policies based on changes in clinical and coding developments, statutes, regulations, and client policies.
The...
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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. They have deep domain knowledge and strong experience in collaborating with diverse teams including product managers, software developers, testers, and teams such as Client Services, Operations, Clinical, Data Science, and Marketing.
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This is a highly visible senior strategic individual contributor role within Cotiviti’s National Accounts segment, with the opportunity to shape growth across some of the most important payer relationships in the market. The role is responsible for accelerating sales growth across Cotiviti’s full Healthcare portfolio by building executive relationships, advancing complex enterprise opportunities, and delivering strategic value to national health plans. Extensive experience and a demonstrated track record of selling enterprise solutions to Health Plan C-level executives, SVP business owners, procurement leaders, VPs, and directors are essential. We are seeking remote candidates across the...
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We are seeking a highly experienced Principal Software Engineer to design and build the backend infrastructure for our centralized AI platform. This role will focus on developing robust, scalable backend services that power our agentic framework and enable teams across the company to securely deploy, manage, and access AI agents through unified APIs and user interfaces.
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We are seeking a Senior Software Engineer to join our team in building the core backend services for our centralized AI platform. This role will focus on implementing backend APIs and services that power our agentic framework, helping teams across the company securely deploy and use AI agents through unified interfaces. The ideal candidate has strong Python skills, eagerness to learn, and interest in working with cutting-edge AI technologies.
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We are seeking an experienced Lead Frontend Engineer to design and build the user interface for our centralized AI platform. This role will focus on creating an intuitive, responsive frontend that enables teams across the company to build, deploy, and manage AI agents through a seamless web application. You'll also develop reusable chatbot modules that can be integrated into various SaaS products within our ecosystem.
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The Medical Policy Director (MPD) is a key member of the Go To Market team. Along with the Client Engagement Leader, Client Medical Director (CMD), the MPD co-captains the team serving the Prospective Payment Management (PPM) client team at the health plan. The MPDs role is to serve as a coding and medical payment policy subject matter expert (SME), with the assistance of a CMD. The MPD is responsible for directing the Medical Policy Committee (joint committee with health plan MD, coding experts, and payment integrity). The MPD will develop a relationship with the client, review their data, select medical policy to present, serve as SME for clinical and coding expertise, and back-end support for...
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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.
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Come join a fun, highly collaborative team and help us find new talent for the business! You will be a true strategic business partner to our hiring teams, with the ability to utilize your recruitment expertise to effectively partner with managers across assigned departments in proactively sourcing, attracting and hiring the best qualified talent.
The Senior Recruiter is a true strategic business partner to our hiring teams, with the ability to utilize recruitment expertise to effectively partner with managers across assigned departments in proactively sourcing, attracting...
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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.
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The Content Analyst II 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.
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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...
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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.
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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...
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The Strategic Pricing, Director is a member of the Corporate Development and Strategy team at Cotiviti. This person will be responsible for leading Cotiviti’s pricing strategy, including maintaining the company’s existing pricing and creating pricing models for new solutions. This person will...
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The Operations Project Manager supports Cotiviti's Retrieval Operations team with new technology initiatives, triage of system issues, client onboarding, process improvement, and general day to day or larger scale projects to ensure the overall success of the department and the revenue the team supports. This role will develop and deliver progress reports, proposals, requirements documentation, etc. Will also identify and manage project dependencies and critical path and track project milestones and deliverables. This role also serves as a project lead for key initiatives.
Cotiviti enables healthcare organizations to deliver better care...
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The Senior Manager, Revenue Cycle Operations leads a team of Business Operations Analysts and Revenue Cycle Specialists supporting Cotiviti’s Clinical Chart Validation (CCV) operations and client delivery. This leader oversees revenue cycle management, month-end close activities, inventory management, client SLA delivery, and financial analysis for assigned clients within the Clinical Chart Validation business unit. The role is accountable for maximizing revenue recognition, minimizing financial leakage, strengthening process controls, and accelerating client savings value while serving as a trusted internal and client business partner. This position also supports workflow modernization through...
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The Policy Integration Coordinator I position holds the primary responsibility for ensuring that each client’s initially chosen policy set & tables have been configured accurately based on the client’s decisions. Manages lower complexity projects. This includes copy of existing payer data, E&M over code, and payer termination projects.
Also loads table mappings for Clinical Chart Validation projects. The Policy Integration Coordinator I provides technical support related to payment policies to the Implementation MD, Implementation Service...
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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.
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The Information Security Engineer’s responsibilities include the build and 2nd level support of key security systems in support of the information security objectives. Operationalizing a wide variety of security systems to include cloud security, IDS/IPS, Next-Gen AV, CASB, email security gateways, SIEM, inventory discovery, and vulnerability management. You will provide training, mentorship, and proper transition of systems to security operations team members. In addition, you will investigate escalated security incidents in partnership with security operations center.
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The Corporate Development Associate is a member of the Corporate Development and Strategy team at Cotiviti. This person will be responsible for evaluating strategic acquisitions for Cotiviti, as well as supporting end-to-end M&A execution and corporate development initiatives across Cotiviti’s portfolio of products. This person will identify and evaluate new opportunities, conduct due...
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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...
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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 Technical Specialist.
This role...
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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.
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This role is expected to work Monday through Friday from 9:00 AM Pacific to 6:00 pm Pacific
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 production, data...
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This role is expected to work Saturday through Wednesday from 9:00 AM Pacific to 6:00 pm Pacific
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 production, data quality, and data...
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Cotiviti is a leading analytics and technology company in the healthcare industry, providing solutions that help health plans and providers improve payment accuracy, risk adjustment, quality, and clinical outcomes. Our payment accuracy platform processes over $800 billion in claims annually, serving more than 30 of the top health plans in the United States.
This is a key role within that is responsible for the development, strategy, and performance of our Coordination of Benefit product line and plays a critical role in driving the success by defining its vision,...
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The Implementation Consultant is a post-sales position focused on individual clients and the implementation of Edifecs solutions they have purchased. This role involves installing, configuring, and overseeing the implementation of Edifecs products for the client. Responsibilities include installing products on Edifecs or client hardware, and configuring and developing programs, tasks, and guidelines to fully implement Edifecs solutions based on the client's specific needs. The Implementation Consultant will serve as the primary technical resource for Client Services, interfacing with the client's technical resources. Duties range from delivering product training to developing and deploying new client-specific requirements. This role...
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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.
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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 Software Engineer is responsible for the design and development of software applications and reusable
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The Rule Value Analysis Analytics (RVA) Product Manager is a visionary, strategic leader responsible for guiding the evolution of the RVA insights platform, a tool that uncovers new savings opportunities for clients. This individual excels in product management best practices, inspires cross-functional teams, and communicates effectively with all stakeholders. The RVA Product Manager is a strong collaborator and communicator, passionate about delivering measurable client value and driving innovation.
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The Cotiviti Retail division are seeking an experienced Scrum Master to lead and support Agile delivery across Retail development teams and initiatives. This role partners closely with product owners, developers, and senior stakeholders to remove impediments, facilitate effective Scrum practices, and drive consistent, high‑quality delivery at scale.
We are looking for a special individual who is not only technically sound but curious and interested in learning our unique and results-oriented...
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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
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The Senior Counsel, Partnerships will be the main legal resource overseeing strategic partnership contracting. The role will also 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...
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The Data Solution Specialist role is aligned to our Implementation team and will partner will various divisions and levels of leadership within the whole organization.
They will be accountable to internal stakeholders for the successful implementation of both new and recurring projects. They will manage milestone tracking and task execution for assigned projects and internal process improvement initiatives. This role involves close collaboration with Product Managers and cross-functional teams to ensure the timely and high-quality delivery of project outputs, such as documentation, data analysis,...
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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...
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We are looking for two highly motivated undergraduate interns to join our team working on next-generation Agentic AI platforms and neural-symbolic systems
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The Coordination of Benefits (COB) Manager works within the COB Business Unit, specializing in managing cases where individuals have multiple health insurance plans. In this role, you'll lead a team dedicated to achieving strategic goals that benefit our team, Cotiviti, and our client relationships.
This role is responsible for leading a team of individuals to meet established goals and deliver financial targets as defined by audit expectations and assists the leadership team with developing the team’s strategic plan for future growth. Additionally, people management, interviewing, forecast and budgeting, and retention efforts as...
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In the role of Concept Development Analyst (CDA) within our CCV business unit, you will support the enhancement and ongoing optimization of claim selection processes and tools, including AI-enabled methodologies. This role is primarily focused on applying deep clinical, coding, analytical, and reimbursement expertise to strengthen and operationalize existing selection strategies.
Leveraging your knowledge of inpatient billing, you will contribute to improvements in proprietary claim selection tools that drive accurate, compliant, and scalable payment integrity outcomes. Your understanding of healthcare payment methodologies, coding behavior, and reimbursement rules...
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In the role of Concept Development Analyst (CDA) within our CCV business unit, you will support the enhancement and ongoing optimization of claim selection processes and tools, including AI-enabled methodologies. This role is primarily focused on applying deep clinical, coding, analytical, and reimbursement expertise to strengthen and operationalize existing selection strategies.
Leveraging your knowledge of inpatient billing, you will contribute to improvements in proprietary claim selection tools that drive accurate, compliant, and scalable payment integrity outcomes. Your understanding of healthcare payment methodologies, coding behavior, and reimbursement...
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This is a senior hunter sales role responsible for selling Cotiviti’s Pharmacy Claim Editing and Payment Accuracy solutions to U.S. health plans, third-party administrators, and self-funded plan sponsors. Target customers include national and regional commercial health plans, Blues plans, Medicaid Managed Care Organizations, Medicare Advantage and Medicare Part D plans, payer-owned PBMs, Third-Party Administrators (TPAs), and administrators of self-funded employer health plans.
The role requires deep experience selling complex healthcare software and...
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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.
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The Senior Implementation Consultant assists in the testing and implementation of Edifecs’ solutions purchased by that client. The Implementation Consultant will generally be involved in installing & configuring under the direction of the Technical Project Manager and/or Implementation/Solution Architect. This includes installation of products on client hardware; configuration and development of programs, tasks and guidelines, and setup to fully implement an Edifecs solution. Duties can range from delivery of product training to new client specific requirements, development and deployment. The role involves client coordination and communication as well as technical understanding...
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Provides analysis of quantitative and qualitative data from internal and external data sources in support of business decisions. Job Duties: Uses standard or ad hoc queries or reports to extract data from disparate databases or data sources. Analyzes data to produce dashboards, metrics, or insights and identify trends or anomalies. Consults with users or decision makers to identify data sources, required data elements, or data validation standards. Collaborates with development teams to design business intelligence solutions to facilitate data gathering, storage, and retrieval. Experience and Education: Performs work under minimal supervision. Handles complex issues and problems, and refers only the most complex...
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The Director of Solution Innovation Strategy leads early-stage solution strategy and innovation shaping for emerging healthcare opportunities. This role identifies, frames, and advances high-value solution concepts at the intersection of healthcare business needs, operational realities, market direction, and enabling technology. The role is translational in nature: it is not a pure product role, pure research role, or pure technology strategy role. Instead, it bridges what is technically possible to what is strategically useful,...
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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.
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The Implementation Consultant assists in the testing and implementation of Edifecs’ solutions purchased by that client. The Implementation Consultant will generally be involved in installing & configuring under the direction of the Technical Project Manager and/or Implementation/Solution Architect. This includes installation of products on client hardware; configuration and development of programs, tasks and guidelines, and setup to fully implement an Edifecs solution. Duties can range from delivery of product training to new client specific requirements, development and deployment. The role involves client coordination and communication as well as technical...
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This is a senior hunter sales role focused on selling Cotiviti’s Dental Claim Accuracy solutions to Dental Benefit Administrators (DBAs) and Health Plans that administer dental benefits. Target customers include organizations such as Delta Dental Plans, MetLife Dental, Guardian, Cigna Dental, Aetna Dental, UnitedHealthcare Dental, Blue Cross Blue Shield plans with dental lines of business, and regional dental administrators.
The role requires extensive experience selling complex healthcare software and services into dental payer organizations, with demonstrated success...