United States · Remote Solely
Overview This auditing role will be responsible for performing retrospective clinical chart reviews on Readmission and Place of Service Claims by utilizing nationally accepted guidelines, clinical review judgment and rev…
Skills: Clinical Chart Review, Medical Auditing, Utilization Management, Case Management, InterQual
United States · Remote Solely
$122k–$155k/yr
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,…
Skills: Project Management, Client Relationship Management, Matrix Management, Health Plan Systems Delivery, Implementation Planning
United States · Remote Solely
$21/hr–$24/hr
Overview A Payment Accuracy, Data Mining (DM) Specialist, is a member of the greater Data Mining Business Unit (BU). Cotiviti's Data Mining team configures custom claim reviews to investigate untapped billing compliance …
Skills: Claim Auditing, Data Mining, Microsoft Excel, Healthcare Billing Compliance, Coordination Of Benefits
United States · Remote Solely
$80k–$112k/yr
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 …
Skills: SQL, PL/SQL, ETL, Data Analysis, RDBMS
United States · Remote Solely
$190k–$225k/yr
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 responsibl…
Skills: Data Engineering, Cloud Platforms, AI Applications, Data Governance, Data Quality
United States · Remote Solely
$32/hr–$40/hr
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 …
Skills: Healthcare Informatics, Agentic AI, Generative AI, Machine Learning, Deep Learning
United States · Remote Solely
$80k–$112k/yr
Overview This role is expected to work Saturday through Wednesday from 9:00 AM Pacific to 6:00 pm Pacific At Cotiviti, we are custodians of data for our clients. Using their technical experience in ETL processes, Data En…
Skills: ETL, T-SQL, Spark, Scala, Shell Scripting
United States · Remote OK
$30/hr–$40/hr
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 improve…
Skills: Retail Auditing, Data Mining, Financial Analysis, Microsoft Excel, Microsoft Access
United States · Remote Solely
$32/hr–$40/hr
Overview 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 Intelli…
Skills: Generative AI, Large Language Models, Machine Learning, Deep Learning, RAG Models
Ciudad de México, Mexico · On-site
$20k–$21k/mo
Overview 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 Coti…
Skills: Auditing, Data Mining, Financial Analysis, English Proficiency, Spanish Proficiency
Ciudad de México, Mexico · On-site
Overview 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 Coti…
Skills: Auditing, Data Mining, Financial Analysis, English Proficiency, Spanish Proficiency
United States · Remote Solely
$115k–$145k/yr
Overview The Public Relations Director leads Cotiviti’s external communications strategy, driving brand visibility, executive thought leadership, and market positioning across the healthcare ecosystem. This role owns Cot…
Skills: Public Relations Strategy, Media Relations, Executive Thought Leadership, Crisis Communications, Corporate Narrative Development
United States · Remote Solely
$20/hr–$23/hr
Overview 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 cover…
Skills: Coordination Of Benefits, Claims Analysis, Data Validation, CMS Guidelines, NAIC Guidelines
United States · Remote OK
$140k–$175k/yr
Overview The Senior Solutions Consultant serves as Cotiviti’s subject matter expert and “voice of product” for our consumer engagement solutions and broader Health Enablement offerings. This role partners closely with Sa…
Skills: Pre-Sales Support, Solution Consulting, Product Demonstrations, RFP Response Development, Healthcare Payer Operations
United States • Remote Solely
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Perform retrospective clinical chart reviews on Readmission and Place of Service claims using nationally accepted guidelines. Document rationales for audit findings and utilize proprietary systems to generate audit determinations and letters.
Requires an active RN license with an Associate or Bachelor's degree in nursing and 5-7+ years of experience with InterQual/MCG. Candidates must have a background in critical care and proficiency in utilization or case management.
This auditing role will be responsible for performing retrospective clinical chart reviews on Readmission and Place of Service Claims by utilizing nationally accepted guidelines, clinical review judgment and review methodologies specific to the contract for which services are being provided. This involves accessing proprietary systems to audit medical records, applying critical thinking and decision-making skills, and accurately documenting a rationale with the findings and supporting references. The ideal candidate for this role would be a Registered Nurse with experience in utilization or case management.
This role will start on 8/3/2026 and will be in training throughout the rest of August until mid September (no time off during this time).
This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.
Base compensation is paid hourly at $45.67 per hour (95k annualized). This role is eligible for discretionary bonus consideration.
Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
Date of posting: 6/12/2026
Applications are assessed on a rolling basis. We anticipate that the application window will close on 7/15/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.
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Enabling a high-quality and viable healthcare system
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. Additionally, Cotiviti offers data management and recovery audit services to the retail sector to improve business outcomes. For more information, visit www.cotiviti.com.
Offices: 10701 S River Front Pkwy, Unit 200, Unit 200, South Jordan, UT 84095, US
Enabling a high-quality and viable healthcare system
Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. Additionally, Cotiviti offers data management and recovery audit services to the retail sector to improve business outcomes. For more information, visit www.cotiviti.com.
Offices: 10701 S River Front Pkwy, Unit 200, Unit 200, South Jordan, UT 84095, US
