careers-cotiviti

Overview 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

Overview The Junior Analyst will play a vital role in supporting various analytical projects and initiatives across different departments within the business unit. Junior Insight Analysts contribute to the organization's success by providing valuable insights that inform strategic decision-making an

Overview This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have a coding/auditing background focused on Inpatient DRG Coding from a coding and billing perspective. This position is responsible for auditing inp

Overview We are looking for an Recovery Resolution Specialist (Collections) to join our Yield Management team! This role will facilitate the collection of funds for the client and maintains exceptional provider relations. Works closely with audit team, payers and providers to understand claims and o

Overview 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

Overview Join a recently formed team focused on Model Risk and Responsible AI. The Senior GenAI Scientist II – Risk will apply knowledge and experience to real world problems and seek to utilize their skills to reduce the cost of healthcare and improve health quality and outcomes. As a Data Scientis

Overview Join a recently formed team focused on Model Risk and Responsible AI. The Generative AI Scientist - Risk will apply knowledge and experience to real world problems and seek to utilize their skills to reduce the cost of healthcare and improve health quality and outcomes. As a Data Scientist

Overview The Product Manager – Fraud, Waste, and Abuse (FWA) is responsible for driving the strategy, development, and lifecycle management of Cotiviti’s FWA product suite, including advanced analytics-driven solutions designed to identify and prevent improper healthcare billing. This role works at

Overview 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 de

Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role. This role aligns with our post-pay Fraud Waste & Abuse team. Responsi

Overview 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 p

Overview This DRG Validation Auditor role is focused on our Cross Claim Clinical Reviews (CCCR). Auditors in this role will be doing DRG Validation for our prepay and retrospective audits and making determinations without a medical record. The ideal candidate for this position needs to have both a s

Overview 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 quali

Overview The Drug and Biological Policy (D&B) Content Analyst II is a key member of the clinical operations and content team and is responsible for the research, quality assurance, and maintenance of existing D&B policies. This individual is expected to define additional logic and algorithms to expa

Overview As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. Responsibilities Conducts audit of medical records and healthcare claims assessing the accuracy of medical coding and determi

Overview As a Senior Investigator, you will investigate suspected incidents of healthcare fraud, waste, or abuse through data analysis (a high level of proficiency with Excel is required). This is not a physical investigator role. This role aligns with our post-pay Fraud Waste & Abuse team. Responsi

OverviewCotiviti works with more than 200 healthcare payers and health systems, including all of the top 25 plans in the United States, to deliver higher-performing payment accuracy, risk adjustment, quality improvement, and consumer engagement programs. We take in billions of clinical and financial

Overview 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 financ

Overview We are seeking a seasoned Director of Data Engineering to lead and scale a high-performing, enterprise-grade data engineering organization for a healthcare company with petabytes of data. This role is responsible for architecting and governing the data infrastructure and drive the technical

Overview This internship centers on researching and developing advanced healthcare informatics solutions with a specialization in Agentic AI—AI systems capable of autonomous reasoning, decision-making, and goal-directed behavior. The intern will explore applications of Agentic and Generative AI in h