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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...
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We are in search of a seasoned Senior AI Developer with a specialization in Azure AI Studio, Azure Open AI, Microsoft Copilots, AI and ML methodologies, and AWS Bedrock. In this role, you will be the guiding force behind our AI initiatives, providing expertise and leadership to all users across the organization who have AI use cases. Your focus will be on architecting, developing, and implementing advanced AI solutions while ensuring alignment with best practices and business objectives.
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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...
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The Associate 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, running, 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 value 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...
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PRINCIPLE PURPOSE OF JOB
We are currently seeking Team Leader to support a growing client base and manage the day-to-day operational activities of the production team and to help stabilization of the process combining their clinical and/or coding expertise with payment accuracy. This includes ensuring that the team delivers as per set expectations while maintaining the required quality standards. The role involves day to day coordination with internal as well external teams
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General Summary:
We are currently seeking Auditor to support a growing client base while combining their clinical and/or coding expertise with payment accuracy. The Auditor is responsible for analyzing and interpreting and assign the correct codes for the descriptions available on various medical procedures and diagnosis and other related medical coding as per the medical policy requirements.
Principal Duties/ Responsibilities:
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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...
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The Senior Data Scientist will join a highly skilled data science team and work directly with a talented team of software engineers, auditors, product managers and customer experience managers to analyze healthcare data and deliver value for our clients.
This is a remote position that can be based anywhere in Australia.
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A Business Analyst (BA) acts as a bridge between business stakeholders and technical teams to identify reporting and analytics needs, analyze operational processes, and deliver data-driven solutions. The BA ensures that business goals are translated into accurate requirements and actionable insights through reports, dashboards, and analytics products that improve decision-making and operational efficiency.
All interviews will be conducted in English.
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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...
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The trainer will oversee developing, managing, and delivering training programs that provide employees with the necessary skills to perform their work in the different audits.
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The Sr. Audit Support Assistant position efficiently and professionally handles more complex, broad daily administrative activities within the audit engagement. Responsibilities include handling multiple
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Edifecs/Cotiviti is seeking a Data Integration Engineer to join our innovative software teams. In this position, you will be responsible for onboarding customers to the Risk Adjustment workflow applications. As part of this role, you will work with platform engineering, product, and implementation teams. The ideal candidate has experience in building scalable data pipelines that enable workflow applications, reporting, and customer confidence. You must have strong, hands-on technical expertise in big data technologies and communication abilities with non-tech and technical audiences.
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This role is remote in Australia. In order to be considered for this role, the candidate must reside in Australia.
Working as a part of our Payment Integrity Practice, the Payment Integrity Specialist provides claims audit and recovery services to our private health insurer clients and provide expert feedback to improve our compliance solutions.
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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...
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The successful candidate must have solid understanding and experience in test case automation and scripting for web applications and microservices/API testing.
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We are seeking a talented and experienced DevOps Engineer to join our team. As a DevOps Engineer, you will play a crucial role in designing, implementing, and maintaining our infrastructure and deployment pipelines. You will work closely with development and professional service teams to streamline our software delivery process, improve scalability, reliability, and security of our systems, and automate repetitive tasks
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We are seeking a Technical team leader overseeing MLOps infrastructure development, integration of toolsets, and deployment automation for ML models.
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We are seeking for an Experienced data scientist leading Intelligent Claims Routing models, developing scoring algorithms and prioritization systems to optimize claims workflows.
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Cotiviti is seeking an experienced Backend Developer to design and build the backend infrastructure for our centralized AI platform. This role will focus on developing robust, scalable backend services that power our agentic framework and enable teams across the company to securely deploy, manage, and access AI agents through unified APIs and user interfaces.
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Cotiviti is seeking an experienced AI Engineer to design, build, and maintain a cutting-edge agentic framework and centralized AI platform that will serve as the backbone of our organization's AI initiatives. This role will be responsible for creating a unified interface that enables teams across the company to securely deploy, manage, and access AI agents while ensuring seamless data integration and platform reliability. The role will work closely with Data Scientists, MLOps engineers, Data Engineers, and Product Engineering teams.
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Cotiviti is seeking an experienced Frontend Developer (IC4) to design and build the user interface for our centralized AI platform. This role will focus on creating an intuitive, responsive frontend that enables teams across the company to build, deploy, and manage AI agents through a seamless web application. You'll also develop reusable chatbot modules that can be integrated into various SaaS products within our ecosystem.
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The Senior Operations Engineer works primarily with enterprise customers of Edifecs Enrollment Management (ENR) products, proactively assisting them with post- implementation support, configuration, upgrade, troubleshooting and day to day operational management. Responsibilities include taking a proactive role working with the Engineering team and Customers to triage and resolve technical, and application-related issues which impact product performance in customer-specific environments, or issues that directly hamper a broader customer adoption of Edifecs products. In addition to working with customers, Senior Operation Engineer will work closely with cross-functional teams, including...
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At Edifecs you’ll be joining the Engineering team responsible for the design & implementation of a multi-tenant SaaS (Software-as-a-Service) platform that is transforming healthcare in claims risk capture and adjustment spaces. As a member of the engineering team, your primary responsibility will be design and implementation for Edifecs’s payer and provider solutions. Your ability to autonomously & proactively drive all aspects of development is a critical requirement.
- We use administrative documentation and patient medical records to understand a...
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Software Engineer is an integral part of our engineering team, responsible for design, implementation, testing and maintenance of innovative software products. The successful candidate must be able to quickly learn the existing systems and components, actively participate in expanding the current systems with new components, as well as develop new components using big data and other emerging technologies.
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At Edifecs/Cotiviti you’ll be joining the Engineering team responsible for the design & implementation of a multi-tenant SaaS (Software-as-a-Service) platform that is transforming healthcare space. As a member of the engineering team, your primary responsibility will be design and implementation for Edifecs/Cotiviti’ s payer and provider solutions. Your ability to autonomously & proactively drive all aspects of development is a critical requirement.
- We primarily work with Java-based solutions and AWS cloud services.
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The Software Engineer is an integral part of our engineering team, responsible for the design, implementation, testing, and maintenance of innovative software products. The successful candidate must be able to quickly learn the existing systems and components, actively participate in expanding the current systems with new functionality, as well as develop new components using big data and other emerging technologies. We are looking for people who have strong knowledge of Java frameworks, and experience in developing server-side and/or client-side web application components.
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The Lead Software Engineer is an integral part of our engineering team, responsible for design, implementation, testing and maintaining of innovative software products. The successful candidate must be able to quickly learn the existing systems and components, actively participate in designing and implementing new components and developing new products using emerging technologies, have experience in shipping user-facing products, working in large code bases, designing and developing features for security, scalability & high availability, managing and mentoring a small team of developers.
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Sr. Software Engineer is an integral part of our engineering team, responsible for design, implementation, testing and maintaining innovative software products. The successful candidate must be able to quickly learn the existing systems and components, actively participate in expanding the current systems with new components, as well as develop new components. Successful candidate must have strong Java knowledge, experience working with server-side web application software for functionality across multiple browser platforms.
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We are currently seeking a manager to manage Medical Coding programs. His/her
Primary responsibility will be to support and monitor day-to-day work processes and meet production and Service Level Agreements. Assessing and forecasting staffing requirements based on client communication and incoming volume. Should coach team members in achieving team deliverables and escalate appropriately and as needed. Monitor activities of team members; provide feedback and counsel team members regarding performance, timekeeping, and personnel issues