The Software Engineer is responsible for the design and development of software applications and reusable software components for the Cotiviti, Inc. (Retail) 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.
This is a hands-on technical role to support our Retail 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,...
The Clinical Consultant support Clinical Services teams in the validation of quality and processes consistency on the Claims Processing Editing Engine (CPE).
Provides support and subject matter expertise on Coding Validation (CV) to both clients and internal stakeholders during the planning, implementation, go-live, transition to operational team, and through the duration of the contract. Clearly understands and articulates CV concepts and policies. Collaborates with internal teams to provide meaningful...
The CIR Manager works with subject matter experts (SMEs) across the enterprise to provide written responses to client information requests (CIRs) and questionnaires. The CIR Manager is responsible for managing the prioritization of CIR requests, negotiating due dates with submitters, escalating issues to senior leadership where appropriate, fostering cross functional communication, and coordinating cross-departmental responses to ensure timely and professional responses to CIR submitters.
The CIR Manager reviews completed requests to ensure responses are reasonable, complete, professionally written, and...
The Sr AI Product Manager - We are seeking a passionate, talented, and enthusiastic individual to join the AI R&D team and help build industry-leading AI technologies, enabling lines of business with cutting edge and impactful solutions. You will lead the strategy, development, and lifecycle of data products that power GenAI solutions across the enterprise. This role bridges the gap between data engineering, AI teams, and business stakeholders to deliver high-impact, reusable data products.
As an AI Program 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
The Sr Staff AI Scientist- Generative AI will apply knowledge and experience to real world problems and seek to utilize their skills reduce the cost of healthcare and improve health quality and outcomes. With access to dedicated on premise and cloud based big data solutions, the team can work with a vast amount of structured and unstructured data including claims, membership, physician demographics, medical records and others to begin to solve some of the most pressing healthcare issues of our time. A Data Scientist at Cotiviti will be given the opportunity to work directly with a team of healthcare professionals including analysts, clinicians, coding specialists,...
The QA I, Clinical Ops position works with the Coding & Clinical Validation Audit team focused on risk coding. The QA position monitors & reports on the accuracy of all code captures on a % of all images of their assigned coders. This position also answers all questions for their coders through the Questions Queue or via email. QA is also responsible for assisting in the remediation for their coders which include full image review of all images coded prior to release to ensure accuracy of image, for any coder below project benchmark.
Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.
The Senior Software Engineer I role is primarily responsible for the support of the existing software applications and enhanced...
The Subrogation Investigation Specialist position is a call center role where your primary responsibility is to support recovery of funds when one of our client’s members has been involved in an accident that was the cause of another party. You will be tasked with researching, documenting, and recording information based on phone calls, emails, and return files from 3rd party sources. We are seeking a talented individual for an Investigation Specialist who is responsible for researching medical claim information from insurance companies, gathering third party information from attorneys and insurance adjusters, and verifying attorney representation and/or liability insurance involvement.
The Senior 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 serve as a key liaison between internal customers and project teams, ensuring the successful implementation of both new and recurring projects. Collaborating closely with Product Owners and Technical Architects, they will define project scope, technical direction, and milestones. This role is responsible for gathering and documenting business requirements, acceptance criteria, and non-functional requirements in alignment with the Scaled Agile Framework (SAFe). Additionally, the...
Technical Architect provides architectural leadership and guidance in their assigned business area, aligning solution development efforts with the broader architectural vision and roadmap. A Technical Architect’s skills and knowledge must include multiple domains (Application/Solution architecture, Technical/Infrastructure architecture, Information/Data architecture), and experience with relevant implementation technology, platforms, and tools. As a leader, a Technical Architect is expected to influence the assigned organization and work independently with senior business and IT leaders, while acting as a mentor and role model within the development teams. The Technical Architect is accountable for successful implementation of...
The Business Systems Analyst role is aligned to our Content and Enablement team within the Enterprise of Data Mining and Yield Management. This role will partner will various divisions and levels of leadership within the whole organization.
A Business Systems Analyst will work alongside Technical Specialists, Analysts, Content and Datameer Managers as well as external departments including any level of leadership to collaborate in achieving the goals established by the department and organization. Knowledge of product management, healthcare and experience as an Agile Product Owner will be critical for success of this role...
Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our healthcare recovery team as a Senior Payment Accuracy Specialist.
The Technical Specialist role is aligned to our Content and Enablement team focusing on Content Optimization. This role will partner will various divisions and levels of leadership within the whole organization.
A Technical Specialist is accountable to internal customers in the pursuit of implementing new and recurring projects. Manages milestone and task execution within assigned projects and internal process improvement efforts. Directly works with product managers and internal cross-functional...
The Senior Technical Specialist role is a key contributor to our Content and Enablement team, playing a crucial role in supporting the Payment Integrity Business Unit. This position collaborates with various divisions and leadership levels across the organization.
The Senior Technical Specialist role will be responsible for working with Product Owners and Technical Architects to define project scope, technical direction, and project milestones. You will have responsibility for working with other stakeholders to define business requirements, acceptance criteria and non-functional...
The Senior Program Manager will partner directly with the assigned Client Engagement Lead, clinical, coding, and reporting team leads and will focus on the execution and delivery of the Cotiviti Prospective Payment Products and Services for an enterprise level account. The Senior Program Manager will directly own and manage enterprise level account activity and is responsible to oversee critical aspects of our engagement for our Prospective Payment solution set. The Senior Program Manager will leverage their deep healthcare, analytics and project management knowledge to deliver the highest quality of services to Cotiviti clients.
Cotiviti is currently looking to add an industry leading Data Scientist I QA, who is focused on machine learning solutions to join our Enterprise Data Science Team and build value-oriented, production level machine learning solutions.
This role is not for research-oriented data scientist, but rather should be of interest to those that want to apply their knowledge and experience to real world healthcare problems and seek to utilize machine learning and artificial intelligence to reduce the cost of healthcare and improve the management of healthcare. With access to dedicated on premise and cloud based big data solutions, this role...
The Systems Engineer is responsible for building, maintaining, securing, and supporting servers, applications, and infrastructure within 24/7 high-performance, highly secure data centers serving a globally distributed customer base. Reporting to IT Management, this role encompasses a broad range of technologies, including both virtual and physical Microsoft Windows and Linux servers, VMware technologies, and public cloud platforms such as AWS and Azure. This position is on-site in our data center in Lynnwood, Washington.
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.
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...
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.
Cotiviti is seeking a passionate and results-driven Customer Program 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, revenue recognition, audit compliance, and risk adjustment. Your expertise will help clients maximize the value of their Cotiviti investment while expanding Cotiviti’s impact across the healthcare payer landscape.The ideal candidate combines strong technical acumen with a deep understanding...
The 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,...
The Vice President, Product Success is a strategic new product launch leader and a member of the Enterprise Product Management team at Cotiviti. This person will play a key role in measuring and driving commercial success of our new product offerings, including understanding and removing barriers to sales and implementation success. In addition, they will be responsible for program and project managing product launch, design and large new product enhancements (from design approval to market general availability) and the championing of product best practices to enable profitable growth across the product portfolio. Reporting to the SVP of Enterprise Product, the Vice President will work in partnership with BU Leadership, Product...
This role is part of the training team for the Clinical Chart Validation team. This position is responsible for improving the technical effectiveness of our teams by planning, developing, and delivering technical training, mentoring, and assessment. The individual will work collaboratively with subject matter experts in the Commercial & Government Audit Teams, Quality Assurance, Concept Development, and others to validate workflows and communication tools to enhance audit productivity, performance, and client satisfaction.
The Client Medical Policy Manager 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.
Cotiviti 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.
What does it mean to be a Payment Accuracy...
The Program Director is responsible for the successful delivery of Cotiviti services to client(s). Responsible for delivery of Cotiviti services to Government client(s) in accordance with client contract requirements. Oversees routine delivery of client services, and responsible for day-to-day management of client relationship and overall contract P&L. Must have strong project management capabilities and assist in scope expansion and implementations. Must track to strategic corporate initiatives that are tied directly to individual account goals and objectives. Strong communicator and collaborator with IT leaders. Strategic thinker and innovator.
Cotiviti, Inc. ("Cotiviti") is a leader in analytics driven healthcare payment accuracy and quality-based solutions and relies heavily on leading-edge technology to deliver these products and services to our wide range of customers.
Strategic Vendor Solutions ("SVS") provides support services to the entire Cotiviti organization for the contracting of vendors who provide products and services, as well as any vendors with potential to join Cotiviti's mission through a joint venture, product development or some other form of strategic...
The Trainer 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.
At Cotiviti, we are custodians of data for our clients. Using their technical experience in ETL processes, Data Engineers ensure operational functions are occurring as expected. This includes but is not limited to managing data implementations, data integrations, data production, data quality, and data security.
The Fraud, Waste & Abuse (FWA) Content Solutions Analyst is a key member of the clinical operations and content team responsible for the research, development, and quality assurance, associated with new FWA conditions. In addition, this position will be responsible for review and analysis of current conditions and assisting in the research necessary to ensure conditions stay current.
The Content Solutions Analyst I 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.
The Senior Attorney supports the VP, Associate General Counsel, advising on artificial intelligence, data rights, technology, and intellectual property issues that impact the company's operations. The position will play a vital role in the Company’s growth by providing strategic legal advice, supporting business operations, and influencing future innovation in the rapidly evolving fields of AI, technology, and data governance. The ideal candidate will possess experience with data rights and AI technology systems and an understanding of privacy rights as it applies to data analytics and technology in the healthcare industry. The candidate will be responsible for advising on solutions that help our clients improve the quality of...
The Implementation Consultant is a post-sales position focused on individual clients and the implementation of Cotiviti's solutions they have purchased. This role involves installing, configuring, and overseeing the implementation of Cotiviti's products at client sites. Responsibilities include installing products on Cotiviti or client hardware, and configuring and developing programs, tasks, and guidelines to fully implement Cotiviti 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...
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
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 an ONSITE POSITION at our Blue Bell, PA location. This is a TEMPORARY POSITION for 4 months.
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.
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
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. 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 skepticism that enhances the work performed in order to achieve success in position.
As a Senior Systems Engineer you will be responsible for resolving escalated service issues, coaching other engineers to resolutions, engineering and implementing complex projects, and for maintaining and overseeing the technology of their assigned areas. This includes VMWare, Windows, and Linux environments.
We are seeking a highly skilled Senior F5 Engineer with a proven track record in enterprise-scale application delivery, load balancing, and secure traffic management. This role requires deep expertise in F5 BIG-IP LTM, iRules...
The Corporate Strategy Associate is member of the Corporate Development and Strategy team at Cotiviti. This person will be responsible for supporting the company’s annual strategic planning process, assisting with new product market research and business cases, and performing analysis and research across a variety of strategic topics. Reporting to the Vice President of Corporate Development and Strategy and working in partnership with Product Leads, the Corporate Strategy Associate will provide support for revenue growth pursuits within and across Cotiviti product areas, supported with analytical rigor.
This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on the following disciplines from a coding and billing perspective: Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the appropriateness of treatment setting and services delivered.
The Cotiviti Retail division are seeking an experienced Manager, Engineering to lead our engineering team and work closely with Retail operations. This individual will play a crucial role in overseeing the development of strategic perspectives regarding IT architecture and business needs. The Manager of Engineering will develop and implement architecture software strategies while exemplifying strong software development experience when working in an Agile environment. This individual will provide guidance to employees in accordance with established policies and management directives.
A Senior Revenue Cycle Specialist is a member of the Revenue Cycle team within the Payment Integrity area of Cotiviti. This department may work directly with other members of Yield to ensure expectations are accomplished. The Sr. Specialist position is responsible for complex levels of recurring and daily functions and processes that are necessary for business execution; including but not limited to, ensuring the quality of various functions within the department (check application, offsets, invoicing, etc.). Other responsibilities will include solving complex issues that have been identified and being a point person for other Revenue Cycle Specialists within the department. A Senior Specialist will...
This role is located in Mexico and can be fully remote if the selected candidate is based outside of a commutable distance to our Mexico City office.
We are seeking an experienced Business Intelligence (BI) Developer to lead the design, development, and optimization of scalable BI solutions that empower our teams and customers with data-driven insights. The BI Developer II will be responsible for developing self-service dashboards, automated reports, extracts and other highly scalable analytics that deliver data-driven insights to customers. This role implements best...
This role is located in Mexico and can be fully remote if the selected candidate is based outside of a commutable distance to our Mexico City office.
We are seeking a skilled and experienced Data Scientist II to join our growing analytics team. This role is ideal for someone with a strong foundation in data science who has demonstrated success independently executing complex analytics projects and developing production-grade machine learning solutions. As a Data Scientist II, you will take a lead role in designing analytical approaches, delivering impactful insights, mentoring...
This role is located in Mexico and can be fully remote if the selected candidate is based outside of a commutable distance to our Mexico City office.
We are seeking an experienced Senior Data Engineer to join our multidisciplinary data product team. This role plays a critical part in architecting, developing, and optimizing scalable data pipelines, enabling advanced analytics and machine learning (ML) solutions across the organization.
As a Senior Data Engineer, you will design and implement robust...
The Senior Data Product Manager drives the discovery, design, development, and implementation of highly scalable analytic tools including self-serve BI dashboards, AI/ML models, automated reports, and curated datasets. This role owns the voice of the customer and partners with data engineers, BI developers, data analysts, and data scientists to develop analytic tools that inform decision-making and accelerate growth. This role also drives the implementation of product management best practices / tools, leads the development of data-driven thought leadership, and mentors junior team members.
The Senior Solution Architect is responsible for creating best-in-class business offerings. This is accomplished through collaboration with business leaders, sales and support teams, and client conversations. The Senior Solution Architect will have responsibility for establishing and sustaining processes and practices that support present and future sales and implementations, ensuring sales are aligned with current technical offering and capabilities, and that custom client requests are substantiated and well understood.
The Senior Solution Architect should have a passion for helping others understand our technical solutions and architecture, creating well defined...