C

Cotiviti

Catches billing errors for health insurers

Team Lead Revenue Cycle

Full-TimeDeadline 10/2/27
$60k - $80k/yr+ Discretionary bonus
Mid
Bachelor's, Associate's
Remote in USA
Remote
AccountingAccounts Payable/Receivable

About the job

Requirements
  • Two to four years of prior work experience in accounting or business operations; healthcare experience with financial systems is preferred.
  • An Associate's or Bachelor's degree in Accounting, Finance, or Business is required.
  • One to three years of people management experience is required for emerging leaders.
  • Ability to lead, influence, manage, and motivate others.
  • Problem-solving, lateral thinking, communication, project management, planning, organizational, and interpersonal skills.
  • Computer proficiency in Microsoft Office, including Word, Excel, and Outlook, is required; Microsoft Access experience is preferred.
  • Demonstrated knowledge of revenue cycle practices.
  • Ability to work with personnel at all levels and exercise discretion with confidential matters.
  • Ability to work both independently and in a team environment.
  • Organizational ability to handle multiple priorities.
  • Must provide a dedicated, secure work area and high-speed internet access, connectivity, and office setup and maintenance.
  • Must be able to perform duties with or without reasonable accommodation.
Responsibilities
  • Train, lead, and provide daily oversight of Revenue Cycle Specialists, while sharing knowledge and refining Revenue Cycle processes.
  • Communicate daily with clients and Claim Audit personnel, field projects assigned by the Manager or Senior Leadership, and respond promptly and professionally to internal and external client inquiries.
  • Ensure operational controls and daily Revenue Cycle processes—including cash application, invoicing, reconciliations, and audit controls—are in place.
  • Monitor work distribution across the team and adherence to internal and external Service Letter Agreements.
  • Hire, develop, coach, lead, and retain team members to build a high-performing team and support customer satisfaction.
  • Delegate work and collaborate with the Senior on new-hire materials and departmental training guides.
  • Analyze revenue streams, identify opportunities to optimize financial performance, and support strategic growth.
  • Collect, analyze, and interpret revenue data across multiple streams, and recommend product or service pricing changes based on availability and expected demand to increase revenue and profitability.
  • Modify revenue management strategies to reach targeted markets.
  • Monitor team or department efficiency and ensure output meets expectations.
  • Implement and administer organizational functions and processes accurately, on time, and in compliance with policies and regulations.
  • Work with the Manager, Revenue Cycle to plan, schedule, and coordinate team work; use metrics to ensure activities follow client and company guidelines.
  • Supervise assigned personnel, client requests, Revenue Cycle workflows, and systems.
  • Serve as a team leader and escalation path for internal and external constituents, providing direction on complex inquiries and problem resolution.
  • Work with the Manager, Revenue Cycle to direct team selection, supervision, evaluation, and development.
  • Set objectives and conduct performance reviews for direct reports with assistance from the Manager, Revenue Cycle.
  • Consult with the Manager and Human Resources to recommend and implement performance management, progression, and compensation actions; resolve employee concerns and sensitive people issues in accordance with HR policies.
  • Support training and career progression, promote knowledge sharing, and work with the Manager to ensure staff training on policies, procedures, and best practices, and maintenance of required education and certifications.
  • Recommend system and process improvements to increase productivity and cost containment.
  • Complete responsibilities outlined in the annual Performance Plan, special projects, and other assigned duties.
Desired Qualifications
  • Healthcare experience, preferably with financial systems.
  • Experience with Microsoft Access.
  • Healthcare experience.

About the company

Cotiviti sells software and review services that help US health insurers pay medical claims correctly, catch fraud, and track the quality of care their members receive. Its software for HEDIS, the care-quality scores US health plans report, has passed certification by the nonprofit NCQA every year since 2001. Insurers run claims through its coding and payment-policy checks before paying them, while its auditors review medical records and paid claims to recover overpayments. Clients pay it software fees or a share of the savings it finds. Cotiviti began in 1979 by auditing retailers' payments to suppliers, which it still does, and it is based in South Jordan, Utah, and owned by private equity firms Veritas Capital and KKR.

Company Size

5,001-10,000

Company Stage

IPO

Headquarters

South Jordan, Utah

Founded

1979

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Simplify's Take

What believers are saying

  • Its results are measurable: in July 2026, Cotiviti reported catching over $10 billion in claim payment errors during 2025.
  • Every employee shares in ownership: Prosperiti, a plan backed by owner KKR, has covered all 9,000-plus staff since September 2024.
  • Room to build AI skills: 20 of Cotiviti's 82 US openings in October 2026 were AI jobs, including three internships.

What critics are saying

  • Expect new bosses: Cotiviti replaced its CEO of 10 years in March 2026 and named a new COO in September.
  • Debt is heavy: a $5 billion bank loan helped fund KKR's 2024 deal valuing Cotiviti at about $11 billion.
  • An AI rival is bulking up: Machinify bought Medicare auditor Performant for $670 million in October 2025.

What makes Cotiviti unique

  • Medicare relies on it: Cotiviti holds three of the five regional contracts to audit paid Medicare claims.
  • Every major insurer is a client: Cotiviti works with all 25 of the largest US health plans.
  • Remote work is the norm: 81 of 82 US openings on Cotiviti's careers site in October 2026 were remote.

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance
  • 401(k) Retirement Plan
  • Paid Vacation
  • Paid Holidays
  • Remote Work Options

Company News

Yahoo Finance
Sep 14th, 2026
Cotiviti appoints Erin Schmuker as chief operating officer to scale operations

Cotiviti has appointed Erin Schmuker as chief operating officer. Schmuker will report to president and chief executive officer Ric Sinclair and join the executive leadership team. Schmuker brings over 20 years of healthcare leadership experience. She joins from Optum, where she most recently served as president of Integrated Pharmacies at OptumRx. Previously, she was managing director of Optum Ireland and UK. As chief operating officer, Schmuker will lead Cotiviti's enterprise operations, focusing on scaling the company's operating model and strengthening execution. She will work to simplify operations and help translate investments in technology and AI into measurable outcomes for clients. Cotiviti describes itself as "The Healthcare Infrastructure Company" and connects data, intelligence, and workflows in the US healthcare system.

Associated Press
Aug 13th, 2026
Cotiviti launches AI-enabled Proactive COB to resolve health insurance coordination at enrollment

Cotiviti has launched Proactive COB, a coordination of benefits capability that uses AI to identify health insurance coverage issues at member enrolment, before claims are submitted. The solution analyses enrollment and maintenance transactions to detect coverage discrepancies early, allowing health plans to prevent payment errors rather than recover overpayments after the fact. Traditional COB approaches rely on retrospective discovery methods, often missing errors until after claims are paid. Proactive COB combines AI-driven prioritisation with validated member databases and over 25 years of COB experience to maintain accurate coverage records throughout the benefit lifecycle. The capability operates on enrollment data and supports automated updates to eligibility platforms, reducing manual intervention whilst maintaining audit trails. Cotiviti's platform serves customers covering over 300 million members and patients in the US.

Yahoo Finance
Aug 4th, 2026
Cotiviti launches AI-powered dental claim accuracy solution amid $198B annual dental spending

Cotiviti has launched an enhanced Dental Claim Accuracy solution on its Payment Policy Management platform to help healthcare and dental payers improve claim processing. The URAC-accredited solution unifies dental and medical payment workflows on a single platform, supporting both batch and real-time processing. The new offering features AI-assisted rule authoring, clinical validation by licensed dentists, and enhanced fraud detection capabilities. It integrates with Cotiviti's Payment Clarity platform to provide explanations of claim decisions and executive reporting. Matthew Hawley, Executive Vice President of Payment Integrity for Cotiviti, noted that dental spending has reached an estimated $198 billion per year. The solution aims to address challenges including fraud, waste, abuse, overtreatment, and miscoding that contribute to improper payments and increased administrative burden for payers.

Yahoo Finance
Apr 24th, 2026
Cotiviti appoints John Hallock as chief corporate affairs officer to lead next growth phase

Cotiviti, a healthcare software and data-driven technology company, has appointed John Hallock as Chief Corporate Affairs Officer. Reporting to CEO Ric Sinclair, Hallock will oversee corporate communications, brand development, marketing strategy and investor relations. The appointment comes as Cotiviti expands beyond healthcare enterprise solutions into a system-level platform operating across the healthcare ecosystem. The company aims to establish a structural utility layer governing financial accuracy and decision-making whilst reducing administrative waste and costs. Hallock brings over 20 years of experience building category-defining companies. He previously led communications and investor positioning for Livongo's IPO and athenahealth's IPO. Most recently, he served on the founding leadership team at Smarter Technologies, helping shape the company's creation, platform build and strategic acquisitions.

Yahoo Finance
Apr 16th, 2026
Cotiviti showcases AI-enabled provider risk adjustment solutions at US healthcare conferences

Cotiviti, a healthcare software and data technology company, is presenting at the ACDIS Conference in Chicago (19–23 April) and NAACOS Spring Conference in Baltimore (22–24 April). The company is showcasing its AI-enabled risk adjustment solutions designed to improve coding workflows and patient outcomes for health systems and accountable care organisations. Cotiviti's expanded provider portfolio combines its clinical expertise with Edifecs' risk adjustment technology, offering capabilities including member suspecting, pre-visit preparation, post-visit review and retrospective coding reviews. The HITRUST-certified solutions aim to improve operational efficiency whilst reducing the need for cost-intensive clinical team reviews. At ACDIS, Cotiviti's Betty Stump will present on navigating risk adjustment challenges and HCC coding standards. Cotiviti's services support over 300 million healthcare consumers across the US.