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 - Java is primarily responsible for the support of the existing software applications and enhance software components deployed in the...

The Content Analyst is a key member of the Content Center of Excellence, responsible for the research and implementation of new and existing medical policies. In addition, the Analyst is responsible for review and analysis of Clinical Content metadata from national sources (CMS, CPT, ICD, etc..) that support the current medical policies in the Cotiviti payment policy library.

The Client Service Analyst (CSA) role ensures adequate support for the client-facing team on coding and policy as well as operational related activities. The CSA must be familiar with the day-to-day activities of the Client Policy Manager (CPM), Client Service Manager (CSM) and client-facing Medical Directors.

The Coordination of Benefits (COB) & Data Mining (DM) Audit Support is a member of the greater Coordination of Benefits and Data Mining teams. This individual will efficiently and professionally handle daily administrative activities within the COB and DM departments to assist the audit to meet and exceed client expectations. This role requires exceptional verbal communication by audio as well as attentive attention to detail for data entry-related written communication and follow–ups for both internal and external client inquiries to achieve success in the generation of overpayments.

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.   The Payment Accuracy, Coordination of Benefits (COB) Specialist 1 position 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...

Cotiviti has multiple openings for full-time coders....these roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule.  

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)....

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.

The Research Medical Director is a key member of the Clinical and Policy research development area at Cotiviti. The Research Medical Director is responsible for providing leadership guidance to the clinical teams and ensuring the Rules and policies are accurately interpreted and developed. This role is also responsible for analyzing, interpreting, and developing additional policies that will allow us to enhance our medical policy library. The Medical Director will guide both internal and external processes as related to Payment Policy Management polices and rules.   This is a...

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 6 months. 

Cotiviti Healthcare is the payment accuracy expert! We work with healthcare organizations to recover money, improve processes, strengthen relationships and maximize their value. As we continue to grow, we are seeking experienced Payment Accuracy Specialists to join our team. This is a great opportunity to join a well-established company with competitive pay, opportunities to develop professionally and excellent benefits.  

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 Integrity space is required with specific experience selling Coordination of Benefits and/or Data Mining solutions being highly desired. We are looking for candidates across the US.

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...

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 Generative AI Developer Intern focuses on researching and developing advanced healthcare informatics, particularly in the realm of Generative AI and emerging Artificial General Intelligence. It is designed to support improvements in healthcare treatment, payment, and operations. The intern will assist and take a primary role in developing, researching, creating analytical materials, and collaborating with various teams to drive AI-related projects.   We are currently looking for interns who can start in...

The Claim Production Analyst II plays an advanced operational role within the Payment Insights Team, responsible for oversight and execution of complex client business processes involving claim production, data management, and claim denial management (RTA). Leveraging deep expertise, Analyst II applies their knowledge and considerable judgement to the completion of root cause analysis to refute historically denied claims, thereby driving client value and supporting internal process improvement initiatives. With significant experience in claims repricing and production, the individual brings expert knowledge of client-specific processing systems and Cotiviti platforms to ensure workflow integrity and quality outcomes. As a highly...

The Project Manager is a role within the Retail business unit who will work cross-function to help manage projects within this business unit. The role is responsible for managing the project from initiation to completion, plus defining ingestion, prioritization and reporting processes.  In this role you will partner with a cross functional team, including Marketing, Go-to-Market Effectiveness, Product, R&D, Operations, and other players to plan, organize and execute project plans.  

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 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 Staff Gen AI Scientist will apply knowledge and experience to real world problems and seek to improve health quality outcomes and reduce the cost of healthcare. 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...

The Director of Engineering AI will drive our AI Platform design across all lines of business. The Director will be responsible for the development and execution of the AI platform and machine learning applications that will empower Cotiviti's Product Groups to deliver innovative AI-powered experiences to our customers.

The Manager Leave Programs leads the strategy, operations, compliance, and continuous improvement of the company’s leave and accommodation programs, including ADA, FMLA, Short-Term Disability (STD), Long-Term Disability (LTD), Paid Time Off (PTO), and applicable state and local leave regulations. This role owns vendor/TPA relationships and partners cross-functionally with HR, Employee Relations, Legal, Payroll, and Benefits to deliver a seamless employee experience, ensure regulatory compliance, and drive data-informed decisions. The Manager will

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...

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...

Perform Dental daily review/audits on client data for completeness and accuracy of coding, utilizing coding background to ensure appropriateness for reimbursement when providing recommendations on clinical claims to the client:  Makes certain the requirements for Current Dental Terminology (CDT), ADA and other related concessions are met. Performs duties according to structured algorithms or other written guidelines. Handles moderately complex issues, refers all medical necessity procedures to higher-level staff for approval or denial. Possesses solid working knowledge of subject matter. High school...

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 healthcare landscape is rapidly changing. As an Associate Software Engineer you will apply your knowledge and experience to real world problems, and seek to utilize Artificial Intelligence, Machine Learning and related technologies to reduce the cost of healthcare and improve health quality and outcomes. With access to dedicated...

The Integration Business Analyst will play a key role in supporting the successful development and implementation of integrated health enablement technology solutions. This position will be responsible for requirements gathering, cross-team coordination, and ensuring seamless integration between multiple technology platforms and services. Together with the project lead and multiple workstream teams, you will be responsible for ensuring a smooth design, build and implement process for our risk adjustment solution initiatives.

The Generative AI Research Engineer Intern conducts primary and secondary research of advanced and emerging healthcare informatics technology with a focus on Generative AI and emerging Artificial General Intelligence technology for healthcare treatment, payment, and operations use cases. Creates research papers, analytical reports, proposals, and educational material. Maintains a deep understanding of technology trends and hands-on experience with relevant technologies. Develops generative AI models, architectures, databases, and systems to improve healthcare solutions.   We are currently looking for interns...

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

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 team as a Product Manager.   This is a key role within that is...

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.   

Cotiviti Healthcare is a leader in payment accuracy services, serving top-tier companies in healthcare and retail. We're actively seeking exceptional tech talents who are passionate about driving innovation, transforming healthcare systems, and accelerating their professional growth. Join our dynamic team of problem solvers and make a meaningful impact in healthcare payment integrity as a Principal Insights Analyst. This role is a key contributor to  healthcare team, playing a crucial role in supporting the Payment Integrity area, and will partner closely with other business...

Cotiviti, Inc. drives better healthcare outcomes through data analytics. 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.   Learn more at www.Cotiviti.com.

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....

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...

The focus of the VP, Senior Client Engagement Lead is to develop and execute against broad relationship, growth, renewal and retention strategies on their customers within the top customer tier. The VP, Senior Client Engagement Lead 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 VP, Senior Client Engagement Lead is accountable for cross-product strategy coordination as well as development and execution against a broad relationship map to drive deep...

The focus of the VP, Senior Client Engagement Lead is to develop and execute against broad relationship, growth, renewal and retention strategies on their customers within the top customer tier. The VP, Senior Client Engagement Lead 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 VP, Senior Client Engagement Lead is accountable for cross-product strategy coordination as well as development and execution against a broad relationship map to drive deep...

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 team as Platform Product Manager.  

The Director of Competitive and Market Intelligence will lead the research and analysis of Cotiviti's competitors, their products, strategies, strengths, weaknesses, opportunities, and threats. The Director of Competitive and Market Intelligence will also lead programs to monitor and report on micro and macro healthcare trends and coordinate with industry analysts, especially those related to payment integrity, quality and performance, risk adjustment, and consumer engagement. This role will provide actionable insights and recommendations to Cotiviti's senior

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 South Jordan, Utah location. This is a TEMPORARY POSITION for 6 months. 

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.  

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.

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. 

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.

This is an onsite position at our Blue Bell, PA office.   In the End User Computing Analyst role, you will provide support for internal employees for all IT services. You will also process incoming technical support incidents and requests through the ServiceNow & JIRA ticket queue while maintaining service level agreements.

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.

Cotiviti is seeking a Director, Engineering Delivery, to work closely with our SVP of Engineering to enforce safe agile processes across the Cotiviti organization at a corporate level for all engineering. This position is responsible for overseeing the full project management life cycle and software development life cycle for the implementation of highly complex, large-scale, strategic Product and business initiatives. The Engineering Delivery Director will be responsible for managing and coordinating a number of key product commercialization, cross functional initiatives, and risk mitigation efforts undertaken by Cotiviti.

The Implementation Consultant is a post-sales position focused on individual clients and the implementation of Edifecs solutions they have purchased. This role involves installing, configuring, and overseeing the implementation of Edifecs products for the client. Responsibilities include installing products on Edifecs or client hardware, and configuring and developing programs, tasks, and guidelines to fully implement Edifecs solutions based on the client's specific needs. The Implementation Consultant will serve as the primary technical resource for Client Services, interfacing with the client's technical resources. Duties range from delivering product training to developing and deploying new client-specific requirements. This role...

Cotiviti is looking for a candidate to join our team as a Regional Vice President, Healthcare Payer Sales. This is a direct sales position with quota responsibility. The ideal candidate will be an articulate, high-energy, self-motivated sales professional with a minimum of 10 years’ experience selling enterprise software solutions to the health insurance industry. If a candidate has experience selling B2B, middleware, data transformation solutions, business intelligence software, or Risk Adjustment that’s a plus. The Regional Vice President, Payer Sales will be responsible for managing all Health Care sales activity for key accounts—growing Cotiviti's revenues and client...

Cotiviti is looking for VP, Corporate Software Architect who understands large-scale, high-performance product designs and principles, AI innovation to drive Agentic Automation, excellent in SaaS designs, thinks cloud natively, shown expertise in converting application to SaaS services, excellent in communicating with critical customers and hands on in solving problems.   As a VP, Corporate Software Architect, you’ll define how to use the latest technologies and AI innovation to identify and optimize the products to scale and perform better. You will work with cutting edge Cotiviti healthcare applications and SaaS services and help...