The Investigator will work as part of a team responsible for investigating Healthcare Fraud, Waste or Abuse. This position partners with more senior investigators and will focus on both analyzing healthcare data, identifying potential FWA, and conducting interviews. This position can be done remote, from your home, in the continental United States.

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 (Coder 2) for full-time permanent positions. See what it's like to work as a Coder at Cotiviti:

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 managing inventory and system alignment between Cotiviti and our clients, reconciling data between different sources, research, and the ability to work with cross-functional teams.

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.

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...

We are looking for a full-time Senior Accountant to join our Financial Reporting team. This role is responsible for assisting with the financial reporting function of the organization. Primary responsibilities include the preparation of financial statements and footnotes in accordance with GAAP, leading the monthly trend analysis, and preparing technical accounting memos. This role will be working cross-functionally with various departments which will primarily include General Accounting, Research and Development, and FP&A. This role will be reporting to the Director, Accounting - Financial Reporting and Investor Relations.

Cotiviti is looking for a motivated and creative Marketing intern to join our dynamic and innovative team for summer 2025, where you can gain valuable experience in the healthcare technology sector. As a Marketing intern, you will have the opportunity to rotate across the different areas of Marketing including: content and communications, strategic conferences and events, public relations & social media, product marketing, operations, performance and analytics, along with creative services. You will work closely with our Marketing leaders...

We are a Healthcare Data Analytics company looking for a Sr Manager of Engineering. In this role you will lead, direct, and manage the day-to-day operations of software engineers and TPOs. You will work closely with other R&D teams, enterprise data management teams, IT, and Client Services teams, as well as the Clinical operations teams. You will manage all the operational aspects of the software development to ensure business and project objectives are met and delivered on time. 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....

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.

Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.   The Sr Software Engineer is primarily responsible for the support of the existing software...

The Quality Analyst II (SW Development) is responsible for performing scenario-based testing from the perspectives of various client roles. The purpose is to investigate problems, identify root causes and document findings to improve software.

Our Healthcare Data Analytics company seeks AVP Engineering within our Payment Integrity business. In this role, you will lead, direct, and manage the cross-functional technology delivery team. You will handle all the operational aspects of software development to deliver business and project objectives. In addition, you will provide technical, administrative, and people leadership for multiple, diverse, geographically distributed teams.

A Senior Revenue Cycle Specialist is a member of the Revenue Cycle team within the Yield Management Division. This department may work directly with other members of Yield to ensure department expectations are accomplished. The Sr. Specialist, Revenue Cycle position is responsible for complex levels of recurring and/or daily functions and processes that are necessary for business execution; including but not limited to, ensuring the quality of various functions within the department (check application, offsets, invoicing,...

The Program Manager, Operations will partner directly with the assigned Client Executive, retrieval, coding, and reporting team leads and will focus on the execution and delivery of the Cotiviti Risk Adjustment Products and Services for enterprise-level accounts. The Program Manager, Operations will directly own assigned accounts and is responsible for overseeing all aspects of our engagement for our Risk Adjustment solution set. The Program Manager, Operations will leverage their deep healthcare and project management knowledge to deliver the highest quality of services to Cotiviti...

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...

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. You will have the ability to solve business problems of moderate scope and deliver insights that enable timely and effective operational decision-making.

This Coding Validation Analyst I position will perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical knowledge and background to ensure appropriateness for reimbursement and will also respond to provider appeals. This position requires strong organizational skills and the ability to meet strict key performance indicators in a fast-paced work environment. Daily, substantive contact with internal staff.    This is a closely monitored productivity-driven role and can be done anywhere in the continental US (this is shift work and hours need to be flexible...this team runs 24 x 7)....

The RegulatoryAttorney supports the VP,Associate General Counselon advising on a wide range of...

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...

We are seeking an experienced and visionary vice president of data ingestion engineering to lead our engineering team and be responsible for one of the most critical products in our portfolio. Our data ingestion is a sophisticated data ingestion solution within the Cloudera ecosystem, responsible for processing 50% of the medical claims in the country. This role demands a leader with deep technical expertise in big...

The Senior 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...

The Policy Integration Coordinator I position holds the primary responsibility for ensuring that each client’s initially chosen policy set & tables have been configured accurately based on the client’s decisions. Manages lower complexity projects. This includes copy of existing payer data, E&M over code, and payer termination projects. Also loads table mappings for Clinical Chart Validation projects. The Policy Integration Coordinator I provides technical support related to payment policies to the Implementation MD, Implementation Service Director...

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...

As a Business Development Representative (“BDR”), you will support the growth of the sales pipeline and expand target account intelligence for Cotiviti. The BDR frequently is the voice of Cotiviti, which sets the tone of the customer experience, particularly in first-contact situations. You will support the management of sales territories by establishing relationships, conducting introductory conversations, and gathering intelligence that enables Cotiviti to favorably compete for the prospects’ business. BDRs support analysis and reporting needs of sales operations by developing business profiles of targeted accounts, also referred to as “New Logos.” BDRs also support marketing program development by...

The Senior Accountant, Revenue Accounting, will participate in a wide variety of tasks including month-end, quarter-end and year-end closing processes, including analyzing and preparing Journal entries, reconciliations and other workpapers and analyses. He/she will also assist in the documentation and compliance of procedures and controls.   This position reports to the Manager, Revenue Accounting.

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...

This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on one of the following disciplines from a coding and billing perspective: SNF, IRF, Home Health, APC, ER, Diagnostics and Professional Service. This position is responsible for auditing outpatient/specialty claims and documenting the results of those audits. with a focus on clinical review, coding accuracy, medical necessity, and the appropriateness of treatment setting, and services delivered.

The 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.   While this team has several areas of expertise, we will be looking to fill this role with a nurse/coder with inpatient DRG experience. 

The Program Manager, Operations will partner directly with the assigned Program Manager, Operations and Program Director in support of a strategic client account. Responsibilities focus on the execution and delivery of the Cotiviti HEDIS/Quality Products and Services. The Program Manager is dedicated to support and manage the strategic client’s account, while being responsible for oversight of all aspects of their medical record retrieval project. The Program Manager will leverage their deep healthcare and project management knowledge to deliver the highest...

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.

The Product Director will drive and own product management functions and the commercialization of products to our partners, working with our internal groups in marketing, sales, and operations.   This individual will have responsibility and leadership for commercial presentation material for existing retail solutions. This role will work with the product team to deliver innovation and revenue growth for new elements of Cotiviti’s retail payment accuracy portfolio including direct ownership of one or more retail products.   

The DevOps Engineer is the primary owner of the build, test, and release (CI/CD) pipeline process in development and production infrastructures. They are responsible for automating software build plans, deploying software to all application environments, and continuously improving release processes using an array of tools.   

The Senior Director, Product Management will lead a matrixed team to drive commercial market success for Cotiviti’s payment integrity offerings. This role will lead the definition and execution of Cotiviti’s market strategy for client solutions including Data Mining (DM), Contract Compliance (CC) and Coordination of Benefits (COB). This individual will understand and prioritize market needs, perform competitive analysis, engage experts within and outside our organization, lead client Product Advisory Boards, define solutions for new market needs, and lead delivery and product launches to expand our client value proposition and advance Cotiviti’s market position.  

In the role of Concept Development Analyst within our Clinical Chart Validation organization, you will lead in the identification, creation, and implementation of innovative concepts within the healthcare billing and coding field. Drawing from your industry experience and knowledge of clinical practices and regulations, you will assist in the development of novel strategies to enhance our claim selection processes. Your proficiency in data analysis,...

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.

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.

We are seeking a highly skilled HubSpot Administrator to manage, optimize, and maintain our HubSpot CRM and marketing automation platform. The ideal candidate will have direct experience serving in HubSpot administration, working across sales, marketing, and customer success teams to improve processes, enhance data integrity, and drive operational efficiency. This role requires strong technical expertise, analytical skills, and a strategic mindset to help maximize the impact of HubSpot within our healthcare B2B SaaS organization.

The Director AI - Risk & Responsible 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. The opportunity includes to to work directly with a team of healthcare professionals including analysts, clinicians, coding specialists, auditors and innovators to...

The Sr Data Scientist - Generative AI II will apply knowledge and expertise to real world problems to enable healthcare organizations to deliver better care at lower cost through advanced technology and data analytics, helping to ensure the quality and sustainability of how healthcare is delivered in the United States. 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...

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 

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.

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.

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 System Architect implements and governs technical architecture development and provides architectural leadership and guidance to align IT solutions and the development organization with the needs of Cotiviti’s Retrieval Operations and the products which it supports.  The System Architect’s skills and knowledge must span the Retrieval domain and include all AWS technologies currently used, as well as those which could potentially be used by Cotiviti to enhance its Retrieval platform.  The System Architect must be an expert in architecting and implementing cloud native AWS solutions incorporating NestJS and Terraform.  The System Architect is expected to...

The Vice President, Sales is responsible for the development and strategic execution of annual sales plans to support the acquisition of new clients and sale of new solutions for the Cotiviti Retail division. This is a hunter role focused on hunting new business for Cotiviti’s Retail Payment Integrity Services and Solutions to the world’s largest retailers, e-commerce, and commercial enterprises. Demonstrated experience calling on and selling to “C” level executives, SVP Business Owners, CFO’s, Procurement, VPs, and Directors is essential.  Experience working in a disruptive software and services sector selling Data Analytics, Payment Integrity / Recovery Auditing services and...

The Medical Director focused on Implementation & Sales is a key member of the Go To Market team. The role is to serve as a coding and medical payment policy subject matter expert (SME). This position is responsible for supporting the sales process for our Payment Policy Management and Clinical Validation lines of business, reviewing and presenting results of the Opportunity Analysis supporting sales, and presenting policy/directing the client toward appropriate policy adoption during the implementation phase.  The Medical Director will then transition the client to a Client Medical Director after approximately 30 days post...