Data Integ Spec Anlytc IT is considered a senior team member that develops, enhances, and provides insight for data integration and serves as a subject matter expert for healthcare claims analysis. This role also provides consultative in-depth evaluation and analytical support to internal and external customers on various projects and conducts detailed claims analysis, assists in model development, assists in statistical analysis, and ad-hoc reporting as prioritized by management. The position communicates the outcomes of analysis to business owners, senior management, and clients in a manner adding insight and value to our clients. This role will spend time working independently, as part of a team, and will focus on specific deadlines as well as exceptional client service. As a senior team member, the ideal candidate problem solves and coordinates the activities of other personnel.

A Manager of Revenue Cycle 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 Manager, Revenue Cycle position is responsible for providing leadership and management for one or more accounts or significant audit support projects. Oversee audit support revenue cycle activities for assigned account to maximize valid claim identification and overpayment recoveries, meet contractual commitments, and deliver customer satisfaction consistent with established operating practices and audit procedures. This will be accomplished through effective financial audit operations management, quality and service assurance, and effective people management and development.

The Data & Insight Analyst is responsible for architecting and developing best-in-class and innovative analytics and reporting solutions. This role will have responsibility for establishing and sustaining processes and practices that support Big Data, Analytics, and Reporting solutions and applications in an Open Source environment. The Data & Insight Analyst should have a passion for data, working with business people, and creating solutions and driving innovation with a keen interest in mentoring and elevating other technical resources. This role will spend time working independently and as part of a team and will focus on specific deadlines in an Agile development process as defined by the management team.

The Claims Production Analyst will manage thorough Review of health insurance claims and member eligibility to locate overpaid claims that are non-compliant or misapplication of contract terms and rates, payment policies, medical policies, billing guidelines, and applicable regulatory requirements.

The Data Scientist I is focused on machine learning solutions in Healthcare Technology and builds value-oriented, production level machine learning solutions. This is not a research oriented data scientist; instead you will apply your knowledge and experience to real world problems, and seek to utilize Artificial Intelligence and Machine Learning to 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 set aggressive goals and execute on them with the team. This is for an ambitious technologist, with the flexibility and personal drive to succeed in a dynamic environment where they are judged based on their direct impact to business outcomes.

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.   

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.

The Business Operations group works in small project teams to identify and address complex business challenges. The team operates like an internal consulting group to define and drive strategic, operational, and organizational improvements across the business. Successful candidates will be self-motivated, intellectually curious, a fast learner, comfortable with ambiguity and working independently, able to focus on details while thinking strategically. They will have the ability to solve business problems of moderate to complex scope and deliver insights that enable timely and effective operational decision-making.

The Software Engineer is responsible for the design and development of software applications and reusable software components for the Cotiviti, Inc. product suite, in compliance with predefined coding standards and technical design. You will be required to collaborate effectively with senior developers, QA, product owners, project management, and other internal stakeholders.   Hands-on technical role to support our audit team through client data conversion and the support, development, and delivery of audit tools and reports. Ideal candidate combines experience with Microsoft Access application development VBA, Project management, Comfort with very large datasets (preferably SQL server) and business understanding to mine data and automate workflows focused on identifying anomalies and errors in our client’s business transactions.  

The Auditor Retail role is an entry level position responsible for auditing client data and/or documentation on behalf of Cotiviti’s clients 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, information, and conclusions drawn to support the work performed so other reviewers may validate claim. Communicates audit recommendations to supervisory auditor for evaluation, verification, and continuous learning.   This position requires candidates to be fully bilingual with a high level of English proficiency (written & spoken).  This role will report to a US based manager who is not bilingual. 

We are eagerly looking for a motivated administrative support person for our Retail Audit team. The formal title is Audit Support Assistant, and this need is for an administrative professional to efficiently and professionally handle the daily administrative activities within the Retail Audit team.  This role will coordinate client meetings, attend meetings to take notes, update status reports, prepare weeky/monthly/quarterly client reporting, and other administrative tasks. 

Our retail recovery auditors are passionate about what they do. They are experts at reviewing, discovering, and validating large amounts of data and delivering results and insights for our clients. Our audit teams recover billions of dollars in incorrect payments for our clients each year. The Auditor position is a key, entry-level role where you will learn from an elite team of recovery professionals, expand your skills, discover your strengths, and begin an exciting career. This is an entry-level role that can work remote from home in the US or Ontario Canada and would be a great fit for a recent college graduate (finance, accounting, etc.).     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. Finding something new—an error in payment, deviation from an agreement, or other undiscovered bits of insight that benefit the client—is what excites us.   We are seeking innovative thinkers and creative problem solvers who are interested in contributing to improving our retail clients’ profitability and want to be part of a team that provides opportunities for career growth. If you want to make a difference and contribute to the improvement of retail payment integrity, consider an opportunity to join our global retail recovery team as a Retail Auditor.

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.   This job can be US-remote or Canada (Ontario area remote).

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. Finding something new—an error in payment, deviation from an agreement, or other undiscovered bit of insight that benefits the client—is what excites us.   We are seeking innovative thinkers and creative problem solvers who are interested in contributing to improving our retail clients’ profitability and want to be part of a team that provides opportunities for career growth. If you want to make a difference and contribute to the improvement of retail payment integrity, consider an opportunity to join our global retail recovery team as an Retail Auditor II.

The Senior Retail Auditor position is responsible for developing new and existing audit concepts, gaining client acceptance, training all audit levels to execute audit projects and evaluating the effectiveness of audit concepts with the goal of auditing client data generating high quality recoverable claims for the benefit of Cotiviti and our clients.

Provides day-to-day supervision and direction to assigned audit team. Ensures operations are running optimally and processes and procedures are being followed. Ensure appropriate staffing levels, and plan and organize workloads and staff assignments according to the needs of the audit. Manages the overall performance, productivity and quality assurance of the assigned audit team. Maximizes opportunities of the audit; optimizes timely audit processes and efficiencies. Involved in formulating all budget related aspects of the audit. Executes and adjusts to budget demands. Drives the profitability of the audit engagement.

The Director, Audit Operations (Retail) position is responsible for providing leadership and management for our vast and expanding global client base. Oversees all audit activities for assigned accounts to maximize team performance, meet or exceed contractual obligations, achieve internal and client financial and operations objectives, and deliver customer satisfaction consistent with established operating practices and audit procedures. This will be accomplished through effective audit operations management, quality and service assurance, and effective people management and development.

The Auditor Retail role is an entry level position responsible for auditing client data and/or documentation on behalf of Cotiviti’s clients 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, information, and conclusions drawn to support the work performed so other reviewers may validate claim. Communicates audit recommendations to supervisory auditor for evaluation, verification, and continuous learning.   This position requires candidates to be fully bilingual with a high level of English proficiency (written & spoken).  This role will report to a US based manager who is not bilingual. 

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.    

The Auditor Retail role is an entry level position responsible for auditing client data and/or documentation on behalf of Cotiviti’s clients 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, information, and conclusions drawn to support the work performed so other reviewers may validate claim. Communicates audit recommendations to supervisory auditor for evaluation, verification, and continuous learning.   This position requires candidates to be fully bilingual with a high level of English proficiency (written & spoken).  This role will report to a US based manager who is not bilingual. 

Accountable to both internal and external customers in the pursuit of implementing new and recurring projects.  Manages milestone and task execution predominantly with client-facing projects as well as some internal process improvement efforts.  Works directly with clients, implementation managers, and cross-functional counterparts to ensure timely and quality output of project deliverables, and acts as a mentor to junior analysts to elevate their productivity.  Project management rigor and best practices application of process excellence, as well as questioning previously established processes and providing creative solutions to achieve time/cost savings, will be of paramount importance in succeeding in this role.

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 seasonal positions.   **Details** This role is seasonal, estimated to last 6 months, starting at the end of May 2024 through January 2025...ongoing seasonal employment will be based on performance.  Available hours will be based on the volume of work but we hope to have up to 40 hours available each week.  Hours can be flexible except for the first week of employment, there will be some required hours.  Experience in HCC/Risk Adjustment coding is required along with an active coding certification through the AAPC or AHIMA (CPC, CRC, CCS, etc.). 

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 for full-time seasonal positions.   **Details** This role is seasonal, estimated to last 6 months, starting at the end of May 2024 through January 2025...ongoing seasonal employment will be based on performance.  Available hours will be based on the volume of work but we hope to have up to 40 hours available each week.  Hours can be flexible except for the first week of employment, there will be some required hours.  Experience in HCC/Risk Adjustment coding is required along with an active coding certification through the AAPC or AHIMA (CPC, CRC, CCS, etc.).    See what it's like to work as a Coder at Cotiviti: https://www.youtube.com/watch?v=-VgcV09cxCo

This is a hunter role selling Cotiviti’s breadth of risk, quality, analytics, and consumer engagement solutions in the healthcare payer space.  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 with relevant health care Quality, Performance Analytics and Risk Adjustment experience is also key.  Deep industry / sales knowledge of all lines of business (Medicare, Medicaid, Commercial) for healthcare quality, risk, and consumer engagement solutions such as HEDIS, Medicare and Commercial Risk Adjustment is highly desirable.  The position will work remotely within the U.S.

This is a hunter role in the healthcare payer space. 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 in the Payment, Analytics or Population Health industry is also key. We are looking for candidates across the US.

Reporting to the VP of Product Marketing, Payment Accuracy, the Product Marketing Manager, Payment Accuracy will primarily utilize their experience to support and develop key areas of the operational and strategic product marketing objectives for the Payment Accuracy Portfolio. This includes opportunities to build awareness for solutions in the market, strategic marketing planning, product launches, lead generation and acceleration of the sales process, develop portfolio of sales enablement tools, product differentiators, understanding of the market landscape, competitive offerings, and the customer buying journey. This position will collaborate across the organization (GTM, Marketing, Product, Business Operations, etc.) to deliver targeted and effective marketing programs aligned with the strategic priorities for Cotiviti to drive opportunities and help to support the revenue goals for the solution area.

The Auditor, DRG Coding & Clinical Validation position has an extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding in reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy.

Sales Solution Manager – Payment Accuracy: Reporting to the leader of Cotiviti’s Sales Solution Management function, the Sales Solution Manager is a sales support, selling and development role dedicated to supporting Sales VPs in the sale of our Clinical Chart Validation, Coordination of Benefits (COB), and Data Mining solutions. This role requires industry and domain expertise in health plan payment accuracy.   Candidate should have at least two years of experience with inside sales, sales development, or a similar customer-facing role within the healthcare industry. They should possess the skill and experience to work as a member of a collaborative sales team and to be responsible for sales quota, expansion of account intelligence, qualification of leads, preparing the sales materials and drive revenue growth.   The intent of the role is to provide support to the Sales VPs in their pursuit of the opportunities. By partnering with a Sales VPs, the Sales Solution Manager will learn best sales practices and efficient use of internal resources.

The SVP, Client Engagement leads the relationship between Cotiviti and our clients and prospects.  This role serves as the client’s/ prospect’s advocate, including monitoring and supporting all activity and managing problem resolution, escalating customer issues quickly, if necessary.  Responsible for managing, tracking, and closing all client issues.

The critical function of a Contract Compliance Senior Auditor is to serve as the lead for contract compliance audit services. This role requires a working knowledge of how to deliver contract compliance audit services in many industries and with a variety of contract types. The work requires the ability to execute audit steps as well as review for accuracy and appropriateness, the work of others, including the assessment of transaction data in relation to relevant contract provisions, and investigation of apparent areas of non-compliance with contract provisions. Successful candidates will be critical thinkers, able to demonstrate the ability to identify risks, develop audit plans, determine necessary data and documents to complete audit testing, and strategic methods for representing, presenting, and securing recoveries for clients, as well as future savings from root cause identification and process improvement recommendations.

The Training Consultant of Implementations is responsible for providing effective and relevant training to our clients through online, in person and recorded sessions. This is achieved through evaluating the Training Request, communicating with the client and the internal support team, and utilizing tools and techniques to deliver on the objectives. They will apply different forms of technology to measure the success of the training and make updates to the strategy based on the results.

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 product suite, in compliance with predefined coding standards and technical design. This person will collaborate effectively and work with Senior Developers, QA, Product Owners, Project Management, and other stake holders. Cotiviti develops highly innovative applications in healthcare analytics to generate performance, improvement opportunities and value for our clients.

The Business Operations group works in small project teams to identify and address complex business challenges. The team operates like an internal consulting group to define and drive strategic, operational, and organizational improvements across the business. Successful candidates will be self-motivated, intellectually curious, a fast learner, comfortable with ambiguity and working independently, able to focus on details while thinking strategically. They will have the ability to solve business problems of moderate to complex scope and deliver insights that enable timely and effective operational decision-making.

The Sr. Product Manager (within Payment Accuracy Product Suite) will be responsible for leading pharmacy / PBM product roadmaps supporting product growth.  This role will enhance and extend the Cotiviti product roadmap for our PBM clients.  This role will serve as product subject matter expert working closely with stakeholders for product requirements, design and delivery.

We are 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 contributing to improving our retail clients’ profitability and want to be part of a team that provides opportunities for career growth. If you want to make a difference and contribute to the service we provide our Retail clients, consider an opportunity to join our global retail recovery team as an Auditor II.   The critical function of a Contract Compliance Auditor II is to audit billings from our clients’ suppliers in order to identify and quantify areas of financial non-compliance with contract terms. The work requires assessment of transaction data in relation to relevant contract provisions, and investigation of apparent areas of non-compliance with contract provisions.  Verified instances of financial non-compliance often result in cost recoveries for our clients, as well as future savings from root cause identification and process improvement recommendations.

The Senior Attorney will provide high quality legal support to the Company, its business units, regional teams, and product and functional teams including sales and marketing, corporate development and other functions. The Attorney will be expected to review, draft, and negotiate a large number of complex client transactions within a corporate environment. The successful candidate will assist the Lead Counsel in advising senior company leadership on legal and risk management issues.

This position is responsible for the Accent Subrogation line of business. The incumbent will fulfill the SAFe Agile development team’s role as the Technical Product Owner.  Responsibilities include gathering and prioritizing product and customer requirements and working closely with product, engineering, sales, marketing, and support teams to meet revenue and customer satisfaction goals.

The Auditor, DRG Coding & Clinical Validation position has an extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding in reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of Cotiviti and our clients. Responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy.

As a Data Engineer, you will work with the team to build complex data pipelines using a new cutting-edge Data Ingestion Platform as well as several new and exciting products in the Big Data/Advanced Analytics space. You will operate in a fast-paced environment where multiple project deliverables are coordinated within specified deadlines. The primary responsibility of this role is to deliver accurate and timely data across various products to enable revenue for the company. The ideal candidate would have data analysis and data pipeline development experience using big data tools (like Spark, Scala, Hive), relational databases, intermediate SQL skills. Healthcare knowledge is a plus.

The Senior Technical Specialist, Team Lead 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. The Team Lead role will maintain responsibilities associated with leading or supervising a team within the assigned project management workspace. This role is considered a mentor, trainer, and developer of less tenured Technical Specialist team members. Additional responsibilities include but is not limited to time sheet review and approval and annual employee performance reviews.   Daily responsibilities include 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 requirement consistent with SAFe (Scaled Agile Framework). You will also handle tracking of project deliverables, as well as issue, change and release management for implementation of desired functionality. You will need to have the ability to execute cross functional tasks in a matrix environment. The Senior Technical Specialist, TL will also perform quality assurance testing, acceptance criteria sign off and accompanying documentation. Additional responsibilities to include product demo, presentation, and training.

As a Technical Specialist at Cotiviti, you will engage in tasks typically associated with Data Integration Specialists/Analysts and ETL Developers. Your focus will be on supporting the design and implementation of data transformation processes that are critical to achieving our strategic business objectives. While you will collaborate with stakeholders to understand business requirements, acceptance criteria, and non-functional requirements in alignment with the SAFe (Scaled Agile Framework), your primary responsibility will be the hands-on execution of these requirements. This places you directly in the flow of transforming insights into action, ensuring that our data processes align with and support our overarching business objectives.   You'll be instrumental in ensuring the seamless integration and processing of large healthcare datasets, leveraging your technical skills to execute data mapping and transformation tasks. By utilizing tools such as Hadoop ecosystem tools (e.g., Hue for running Hive and Impala queries), you'll analyze and validate data, preparing it for impactful use across the organization. Your role is vital in tracking project progress, identifying issues, and supporting change and release management activities to implement functionality that meets or exceeds our expectations.   Ideal candidates for the Technical Specialist role are those who have a solid background in data management or related technical disciplines and the ability to quickly learn and apply new technologies. If you're keen on keeping up with the latest trends in data integration and have a proactive mindset towards developing and applying innovative data management strategies, you're the type of candidate we’re looking for. Professionals with experience in healthcare data are especially encouraged to apply. This role presents a distinctive opportunity for personal and professional growth within a nurturing environment, allowing you to hone your expertise and play a significant role in advancing Cotiviti's data management initiatives.

The Client Medical Director (CMD) is a key member of the Go To Market team. Along with the Client Engagement Leader, the CMD co-captains the team serving the Prospective Payment Management (PPM) client team at the health plan. The CMDs role is to serve as a coding and medical payment policy subject matter expert (SME). The CMD is responsible for directing the Medical Policy Committee (joint committee with health plan MD, coding experts, and payment integrity). The CMD 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 the client’s Medical Director. The CMD will evolve as the trusted advisor for the Health Plan in terms of medical payment policy.

The Records Processing Agent processes incoming and outgoing mail containing medical records and requests for records as well as document reproduction while maintaining production and quality levels through tracked metrics. This is anONSITE position at our Blue Bell, PA location. This is aTemporary position, approximately 8 months.   Pay rate is $17.20/hour.

This role requires proven multitasking and problem-solving skills, capable of working autonomously or in a team, adaptable to dynamic environments. Key responsibilities include managing learning management systems, supporting software queries, processing enrollments, and maintaining partner relationships. They possess strong communication skills, technical proficiency in HTML and Microsoft applications, and a solid understanding of training best practices. The role may involve up to 25% travel.

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 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 should have experience designing, building, and supporting complex database applications in an enterprise environment and have proficiency in PL/SQL and Java. The developer should also be able to solution and contribute independently with little or no guidance. The ideal candidate will have prior experience leading and architecting in an enterprise environment and contribute as a developer helping deliver against challenging deadlines.

This is a hunter role selling Cotiviti’s breadth of solutions in the healthcare payer space. 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 with relevant health care payment accuracy, payment integrity, FWA, Quality, Performance Analytics and/or Risk Adjustment is also key. Deep industry / sales knowledge of all lines of business (Medicare, Medicaid, Commercial) for healthcare payment, quality, and risk solutions such as claim editing, clinical chart  review, coordination of benefits, data mining and/or fraud, waste and abuse market, HEDIS, Medicare and Commercial Risk Adjustment is highly desirable. The position will work remotely within the U.S.

The Data Scientist I is focused on machine learning solutions in Healthcare Technology and builds value-oriented, production level machine learning solutions. This is not a research oriented data scientist; instead you will apply your knowledge and experience to real world problems, and seek to utilize Artificial Intelligence and Machine Learning to 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 set aggressive goals and execute on them with the team. This is for an ambitious technologist, with the flexibility and personal drive to succeed in a dynamic environment where they are judged based on their direct impact to business outcomes.

We are eagerly looking for several motivated administrative professionals for our Retail Audit team in our new Mexico City office. In this role, you will efficiently and professionally handle the daily administrative activities within the department, to assist our retail auditor(s), collectors, managers, Business Optimization and others to meet and exceed customer expectations. You will act as a point of contact for the audit team in facilitating responses to general inquiries and data requests from both internal and external customers. This role is an excellent way to "get your foot in the door" and learn the business so that you can grow with the company as we expand.  Must be bilingual in English and Spanish; all interviews will be conducted in English.  

The Data Integration Specialist 1 develops, enhances, and provides insight for data integration and serves as a subject matter expert for healthcare claims analysis utilizing both technical expertise and business acumen. This role also provides consultative analytical support to internal and external customers on various projects and conducts detailed claims analysis, assists in model development, assists in statistical analysis, and ad-hoc reporting as prioritized by management. The position communicates the outcomes of analysis to business owners, senior management, and clients in a manner that adds insight and value. This role will spend time working independently, as part of a broader team, and will focus on specific deadlines as well as exceptional client service.

The Sr. Software Engineer is primarily responsible for the performance and stability of critical applications. You will be expected to implement changes, bug fixes that support onboarding of new clients and quick resolution of production issues.  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.