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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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The Technical Program Manager is responsible for overseeing the execution of complex initiatives. These initiatives require coordination of teams using a variety of software delivery practices that will include SAFe. The Technical Program Managers collaborate closely with cross-functional teams to ensure projects are delivered on time, within budget, and meet the required quality standards. Programs can involve simultaneous coordination across the Executive, Finance, Operations, Sales, Marketing, Product Management, R&D, Legal, Compliance, Client Implementations and external vendors. The Technical Program manager needs strong leadership and problem-solving skills to achieve successful outcomes....
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Cotiviti is seeking a forward-thinking Technical Architect to join the team. This is a high-impact, hands-on leadership role responsible for defining and governing the end-to-end technical architecture of a mission-critical Commercial & CMS audit platform — while simultaneously driving the platform’s AI-native transformation.
The ideal candidate brings deep enterprise architecture expertise, proven...
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A Scrum Master (SAFe) is responsible for facilitating the adoption and implementation of the SAFe (Scaled Agile Framework) methodology within an organization. They provide coaching and guidance to the development teams, product owners, and stakeholders, helping them understand the principles and practices of SAFe and ensuring smooth implementation. Overall, a Scrum Master (SAFe) plays a crucial role in promoting and implementing the SAFe methodology in organizations to deliver high-quality products and achieve business goals in a scaled agile environment.
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The Client Solution Specialist I Retail is a key member of the Cotiviti Retail team, responsible for supporting client relationships, managing client enhancement requests, and providing application support. This role is ideal for a client-focused professional with experience in a retail-related industry, strong written and verbal communication skills, and the ability to analyze complex information in a dynamic, matrixed environment.
In this role, the Client Solution Specialist supports the successful delivery of solutions and services for strategic clients across the...
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The Senior Program Manager, Operations partners closely with assigned Client Executives and internal delivery teams to lead the execution, coordination, and ongoing delivery of Cotiviti’s Quality, Value‑Based Payment, and related platform solutions. This is a dedicated role serving as the primary day‑to‑day program lead for a strategic client and is accountable for overseeing all aspects of the client engagement across multiple products, teams, and workflows. The Senior Program Manager applies deep healthcare domain knowledge in Value Based...
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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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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 post-pay Fraud Waste & Abuse team.
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The Talent Acquisition Sourcer is responsible for identifying, engaging, and attracting top talent to support our organization’s hiring needs. This role partners closely with Recruiters and Hiring Managers to understand workforce plans, build diverse pipelines, and deliver high‑quality candidates for current and future openings. The Sourcer will leverage market insights, sourcing tools, and creative strategies to find and engage passive candidates while ensuring a strong candidate experience that reflects our employer brand.
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A Payment Accuracy, Coordination of Benefits (COB) Senior Specialist, is a member of the greater Coordination of Benefits Business Unit (BU). Coordination of Benefits involves situations in which an individual is covered by two or more health plans. Individuals in the Senior Specialist role are passionate about what they do and are subject matter experts (SMEs) at identifying opportunities for strategic growth, reviewing, discovering, and validating substantial amounts of data, to deliver results and insights for our clients.
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The Sr. Project Manager will be responsible for managing and coordinating multiple implementation projects within Cotiviti. This role will serve as the primary liaison between the Customer teams and the Cotiviti teams including implementation/delivery, Product and other relevant teams as necessary, ensuring that products/solutions delivered align with agreed upon Customer requirements and scope. The successful candidate will also be responsible for capturing Customer feedback, understanding the reasons behind any gaps, and managing the process to triage and resolve these gaps. The candidate will also lead or support the internal delivery teams from program coordination, communication, execution, and management standpoint.
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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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Cotiviti is a leading provider of data-driven solutions that help healthcare organizations, retailers, and payers improve financial performance and operational efficiency. Our mission is to deliver actionable insights through advanced analytics, innovative technology, and deep domain expertise. As part of our engineering team, you will contribute to building scalable, secure, and high-performing systems that power critical business processes and enable better outcomes for our clients.
The Staff Engineer I is a senior technical engineer responsible for...
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This is a sales leader role focused on leading at team of field sales executives selling Cotiviti’s healthcare Payment Accuracy solutions in the healthcare payer space. Experience leading sales teams is required as is extensive experience calling on and selling to Health Plan “C” level executives, SVP Business Owners, procurement, VPs and directors is essential. Experience working in a leading Health Plan software and service vendor selling Payment Accuracy solutions including claim editing, data mining, coordination of benefits, clinical chart validation and/or fraud, waste and abuse detection is also key. We are looking for candidates...
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The Intern Technology Solutions Analyst is responsible for researching technologies and use cases for Cotiviti solutions. This internship role will report to the Director of Health Tech Research and work on Technical Prospecting within the Research and Development department. Technical 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.
Preferred location is South...
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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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The Associate Release Train Engineer will be part of Cotiviti’s Innovation Portfolio Management (IPM) team and will support the management of critical projects within an Agile Release Train (ART) and across matrixed teams. Candidate must have experience in the Scaled Agile Framework (SAFe). Candidate must have understanding of best scrum and agile practices at the Team and Program levels, including being able to guide and coach Agile Teams on Cotiviti and SAFe processes and best practices. Longer term emphasis will be on supporting the RTE in program delivery and risk management (ART coordination) and portfolio management reporting needs for the IPM team.
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Cotiviti focuses on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality.
Our software engineers enable insurance companies to identify risk associated within their membership population, allowing insurance companies to direct resources to members most in need.
If you are looking for an opportunity to lead software...
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Cotiviti focuses on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality.
Our software engineers enable insurance companies to identify risk associated within their membership population, allowing insurance companies to direct resources to members most in need.
If you are looking for an opportunity to lead software...
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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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Cotiviti focuses on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality.
Our software engineers enable insurance companies to identify risk associated within their membership population, allowing insurance companies to direct resources to members most in need.
If you are looking for an opportunity to lead software...
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Cotiviti is looking for a Director of Engineering within our payment Integrity and audit recovery business. In this role you will lead, direct, and manage the day-to-day operations of software engineers and data analysts. You will work closely with business leaders, enterprise data management, engineering and IT. You will manage all the operational aspects of the audit tool implementations and data analytics to ensure business and project objectives are met. You will provide administrative, technical, and people leadership for multiple, diverse, and geographically distributed teams. You are responsible for providing feedback to the team and individuals on their performance. You will coach and guide teams to enable...
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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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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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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 post-pay Fraud Waste & Abuse team.
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The AI & Automation Intern will assist in designing, building, and experimenting with AI-driven and automation-based solutions that support internal and customer-facing products. The intern will work on an identified backlog of AI, automation, and innovation initiatives, as well as explore and prototype new ideas to improve efficiency, intelligence, and scalability across platforms.This role is ideal for candidates with a strong interest in artificial intelligence, automation, and modern software development, including working with APIs, data pipelines, large language models (LLMs), and workflow automation tools. The intern will...
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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...
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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.
This role 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 Coordination of Benefit claims for the benefit of Cotiviti and our clients. This individual works under limited supervision and is responsible for establishing...
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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 Senior Software Engineer role is primarily responsible for the support of the existing software applications and enhanced...
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Cotiviti is looking for an enthusiastic and dedicated Account Manager (AM) who is motivated to support the transformation and improvement of our nation’s healthcare system through the use of healthcare consumer engagement. The AM role is a critical, client-facing position with both internal- and external responsibilities. The AM is assigned ownership of an existing set of accounts and has primary responsibility for maintaining and increasing revenue within their assigned accounts. This includes the upsell of Consumer solutions through “farming” within their assigned account base. The AM also owns all satisfaction, renewal, and retention efforts. The AM...
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The Content Solutions Analyst II (RX) 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.
Specific to this role we are looking for a pharmacist to work on our pharmacy claims editing policies.
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The Subrogation Sr. Specialist, Team Lead is a people leading position responsible for leading a team of Subrogation Investigation or Recovery Specialists. The Sr. Specialist, Team Lead will be tasked with monitoring and supporting production by ensuring individuals are appropriately trained and equipped to meet productivity standards. They will also be responsible for ensuring we adhere to a high standard of quality to maintain a positive relationship with clients, attorneys, and members. Successful performance in this position facilitates the effectiveness of the audit, the quality of the results delivered, appropriate retention of records, and enhances the professional image and reputation...
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The Senior Project Manager is responsible for leading large-scale, cross-functional, enterprise-wide initiatives with significant executive visibility and business impact. These initiatives may include post-merger integrations, international operational efforts, systems implementations, strategic transformation programs, and other high-priority enterprise projects as assigned.
Given the complexity and variability of each initiative, the Senior Project Manager must apply a diverse range of project management tools, frameworks, methodologies, and leadership approaches to...
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Cotiviti is seeking a passionate and results-driven Technical Customer Solutions Manager to join our team and play a key role in driving long-term success for our clients through the effective use of Cotiviti products. In this strategic role, you will act as a trusted advisor to our healthcare payer clients, leveraging your deep operational knowledge of data processing systems, regulatory compliance, and enterprise system integration. Your expertise will help clients maximize the value of their Cotiviti investment while expanding our impact across the healthcare payer landscape. The ideal candidate combines strong technical acumen with a deep understanding of healthcare EDI operations, encounter data...
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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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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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We are seeking a passionate, talented, and enthusiastic AI Product Manager to join the AI R&D team and help build industry-leading AI technologies, enabling lines of business with cutting edge and impactful solutions. Not only would you accelerate the adoption of AI but also push the boundaries of advanced ML and Generative AI techniques at scale.
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The Policy Design Specialist role is responsible for managing health plan clients and executing monthly project requests. Perform policy configuration maintenance of current medical policies along with implementing new health plan medical policies per client request. Adhere to and remain in alignment with the most up to date healthcare industry medical coding guidelines. Perform data analysis to determine how to accurately apply coding updates and client requested customizations. Execute quality assurance checks to ensure appropriate claim editing recommendations are applied based on client request.
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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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The Senior Integration Solutions Engineer Level II will play a key role in building and supporting integration solutions within the company’s software ecosystem. This role requires close collaboration with clients, business teams, developers, and infrastructure providers to design and implement scalable, high-quality integrations that meet business needs. As a senior technical contributor, you will also mentor junior engineers, develop best practices, and ensure that integration processes are efficient, reliable, and aligned with the company’s goals. Additionally, you'll have the opportunity to research emerging technologies, enhancing integration capabilities and driving innovation.
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The Sr. Auditor, Quality Assurance position is responsible for ensuring that the audited claims meet quality standards necessary to generate high quality recoverable claims for the benefit of Cotiviti and our clients. Audited claim types include: Outpatient and Specialty Review Types to include SNF, IRF, HH, DME, Hospice and medical necessity. Quality assurance emphasizes compliance with established procedures, accuracy of claim identification and supportive documentation. Identifies and notifies management of observed quality and communicates opportunities for process improvements based on independent audit claims review. Displays professional...
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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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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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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.
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We are looking to hire Senior Software Engineer - Full Stack to support CCCR (Cross Claim Clinical Review) as an innovative approach to inpatient clinical reviews, currently available through our Retrospective CCV program. This initiative will extend CCCR to prepay and expand into outpatient and professional claim review as part of PPM to CV. Physician claims are submitted before hospital claims approximately 60% of the time. This enables capturing 60% of retrospective CCCR savings prepayment, accelerating revenue realization and reducing costs. The remaining 40% of savings will continue to be recovered through retrospective CCCR-CCV.
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The intern will assist with a Principal Diagnosis AI Audit project. We're looking for a student intern, in a HIM related degree program, who has already completed a medical coding course (preferably inpatient coding). You will be using that coding knowledge to review AI related decisions, from a test environment, and identify missed coding/auditing opportunities. This work will support innovation across the Clinical Chart Validation Team’s audit selection pipeline. This will be a strong learning opportunity to gain hands-on experience in audit analytics, opportunity assessment, and cross‑functional...
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The Clinical Delivery SharePoint Organization Intern will support the Clinical Delivery department by organizing, standardizing, and improving the usability of the department’s SharePoint site. This internship is a short‑term, project‑based role focused on inventorying existing content, improving document structure and naming conventions, and enhancing overall accessibility and usability of departmental resources, including expansion of the chatbot capabilities. The intern will collaborate with department leadership and subject matter experts to ensure content is logically organized, current, and aligned with departmental and information governance standards.
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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.
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This is a hunter role in the healthcare payer space. Experience selling to Health Plan executives at the C-Suite and VP levels is essential. Experience working in a leading Health Plan software and service vendor in the Consumer Engagement and/or Population Health industry is also key.
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The Intern Cloud Engineer will focus on developing, optimizing, and supporting cloud-based solutions within Cotiviti’s AWS environment. This internship role reports to the Associate Director AGI Research. This role will focus on leveraging cloud technologies to drive innovation, efficiency, and scalability.