Full-Time

Coder 1

HCC Risk Adjustment

Updated on 8/1/2026

Deadline 7/29/27
Cotiviti

Cotiviti

1,001-5,000 employees

Healthcare payment accuracy analytics provider

Compensation Overview

$23 - $26.50/hr

+ Discretionary bonus

Remote in USA

Remote

Fully remote within the US. Training requires Monday-Friday, 8 AM-5 PM Eastern Time; working hours are 40 hours per week during daytime hours in the employee's time zone.

Category
Medical, Clinical & Veterinary (1)
Required Skills
Medical Terminology
HIPAA

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Requirements
  • A minimum High School Diploma is required.
  • A nationally certified coder in good standing through AAPC or AHIMA is required, such as CRC, CPC, or CCS.
  • Coder 1 requires 1-2 years of experience in medical risk adjustment or HCC coding.
  • Experience in HCC record abstraction and coding requirements is required.
  • Demonstrated high quality accuracy and productivity in clinical coding work are required.
  • The professional credential must remain in good standing as required by AAPC and/or AHIMA.
  • Adherence to official coding guidelines, coding clinic determinations, Centers for Medicare & Medicaid Services guidelines, client-specific guidelines, and other regulatory compliance guidelines and mandates is required.
  • Strong knowledge of medical terminology, anatomy, and physiology is required.
  • Intermediate computer skills and knowledge are required, including the ability to use the designated coding platform for coding processes with focus on production and accuracy.
  • Organization and time-management skills are required.
  • The ability to read and understand medical record documentation for diagnosis extraction is required.
  • Comfort with computers and technology is required.
  • Compliance with all HIPAA and associated patient-confidentiality requirements is required.
  • Training requires Monday-Friday availability from 8 AM to 5 PM Eastern Time.
  • The role requires 40 hours per week, Monday-Friday, in eight-hour daytime shifts based on the employee's time zone; it is not intended to be nights, weekends, or part-time work.
  • Excellent written and communication skills are required to understand and explain complex information.
  • The ability to consistently achieve over 95% quality accuracy is required.
  • The ability to communicate appropriately with management regarding workload, production expectations, and deliverables is required.
  • The ability to learn quickly and work in a fast-paced environment is required.
  • The ability to manage and meet deadlines is required.
  • Adaptability to changing priorities and openness to new ideas are required.
  • Participation in all required training is mandatory.
  • The employee must provide a dedicated, secure work area.
  • The employee must provide high-speed internet access and maintain the required office setup.
  • The role requires remaining stationary, often standing or sitting for prolonged periods, and performing repetitive motions involving the wrists, hands, or fingers.
Responsibilities
  • Review medical records for accurate, compliant, and complete diagnosis-code abstraction from a variety of chart and encounter types to support Medicare, Commercial, and Medicaid prospective, concurrent, and retrospective risk-adjustment program initiatives.
  • Stay current on coding guidelines necessary for the position by attending required trainings and workshops and conducting personal research as appropriate.
  • Communicate findings, errors, and suggestions professionally to the Team Lead to support ongoing communication and efficient department operations as part of continuous improvement.
  • Complete all responsibilities outlined in the annual performance review and/or goal setting.
  • Complete special projects and other duties as assigned.
  • Perform duties with or without reasonable accommodation.

Cotiviti provides healthcare data analytics and payment integrity services for health plans, providers, and retailers. It uses analytics and technology to review medical claims before and after payment to identify improper or duplicate payments, validate coding, and recover overpayments. The company combines capabilities from its predecessors (Connolly and iHealth Technologies) into a single end-to-end platform for pre-payment and post-payment review, enabling more accurate, efficient claims processing. Compared with competitors, Cotiviti leverages its large-scale data assets, extensive experience in healthcare payer analytics, and a broad, end-to-end workflow that covers the full lifecycle of claims payment and audit. Its goal is to reduce waste and abuse in the U.S. healthcare system by improving payment accuracy and recovering improper payments across the claims process.

Company Size

1,001-5,000

Company Stage

IPO

Headquarters

South Jordan, Utah

Founded

1979

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Simplify Jobs

Simplify's Take

What believers are saying

  • AI-enabled risk adjustment workflows reduce manual chart review costs for providers.
  • Edifecs integration strengthens Cotiviti’s coding automation and retrospective review offerings.
  • Ric Sinclair’s Waystar background supports sharper platform execution and enterprise sales.

What critics are saying

  • UnitedHealth Optum and Change Healthcare can bundle competing review tools into claims systems.
  • Leadership transition from Emad Rizk to Ric Sinclair disrupts sales momentum and renewals.
  • Retrospective audit demand erodes if payers shift to real-time payment controls.

What makes Cotiviti unique

  • Merged Connolly and iHealth in 2014, combining post-payment and pre-payment accuracy.
  • Serves over 300 million healthcare consumers with analytics-driven payment accuracy tools.
  • Expanded into a healthcare infrastructure platform across financial accuracy and decision support.

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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

Business Wire
Mar 9th, 2026
Cotiviti appoints Ric Sinclair as CEO to drive healthcare platform innovation

Cotiviti, a healthcare software and technology solutions provider, has announced a leadership transition. Ric Sinclair will join as chief executive officer and board member on 16 March 2026, whilst Emad Rizk will transition from CEO, president and chairman to senior adviser. Dr Rizk led Cotiviti for a decade, overseeing transformational acquisitions including Edifecs and expanding the company's market presence in partnership with Veritas and KKR. Sinclair joins from Waystar, where he served as chief business officer and helped build a high-growth enterprise technology platform. His focus will be accelerating Cotiviti's transformation, expanding its platform and delivering efficiency improvements across medical and administrative challenges. Cotiviti's technology serves customers providing coverage and care for over 300 million members and patients across the United States.

PR Newswire
May 5th, 2025
Cotiviti Selects The Casepoint Platform For Its Innovative Technology

OPEXUS + Casepoint signs a multi-year contract with Cotiviti to automate the company's internal and external litigation-related processes with a secure and unified legal hold platform.WASHINGTON, May 5, 2025 /PRNewswire/ -- Cotiviti, a leader in data-driven healthcare solutions, has selected the Casepoint legal hold management solution from OPEXUS + Casepoint to support internal investigations and litigation workflows within a single, secure platform. OPEXUS + Casepoint, the trusted leader in regulatory and compliance workflows across corporate and government enterprises, today announced that it has signed a multi-year contract with Cotiviti to provide its powerful, end-to-end legal hold management and eDiscovery platform to the technology and analytics company

HIT Consultant
Dec 5th, 2024
Cotiviti Appoints Suvajit Gupta As Chief Technology Officer

Cotiviti Appoints Suvajit Gupta as Chief Technology Officer. by Healthcare Executives Hires 12/05/2024 Leave a Comment. Suvajit Gupta, Chief Technology Officer at CotivitiWhat You Should Know: – Cotiviti, a provider of data-driven healthcare solutions, has appointed seasoned technology leader Suvajit Gupta as its new Chief Technology Officer (CTO). – Gupta brings over 30 years of experience in technology leadership to Cotiviti, where he will play a key role in shaping the company’s technology strategy and driving innovation across its portfolio of solutions for healthcare payers and retailers.Gupta Bio/BackgroundGupta joins Cotiviti from Appian Corporation, where he served as executive vice president of engineering for over a decade. During his tenure at Appian, Gupta led a large team of engineers and spearheaded significant advancements in the company’s low-code platform, transforming the user experience for building and deploying web and mobile applications. Prior to Appian, Gupta held leadership roles at Eloqua, further demonstrating his expertise in enterprise software development. He will report directly to Dr

Cotiviti
Jun 3rd, 2024
Cotiviti Completes Recapitalization with KKR and Long-Standing Owner Veritas

Cotiviti announced today the close of its business recapitalization with two premier firms, affiliates of its long-standing partner Veritas Capital (Veritas) and investment funds managed by KKR.

Business Wire
May 2nd, 2024
Cotiviti Completes Recapitalization With Kkr And Long-Standing Owner Veritas

SALT LAKE CITY--(BUSINESS WIRE)--Cotiviti, a leading healthcare data analytics and technology business, announced today the close of its business recapitalization with two premier firms, affiliates of its long-standing partner Veritas Capital (Veritas) and investment funds managed by KKR. KKR and Veritas are now co-sponsors with equal ownership stakes in Cotiviti. Cotiviti’s mission is to improve the healthcare system through its combination of advanced technology, data analytics, and specialized expertise. Its dynamic, integrated SaaS solutions enable health plans to solve their biggest challenges by closing care gaps, helping to ensure claims are appropriately reimbursed, capturing population risk accurately, and engaging consumers through highly tailored, multichannel approaches. “This is a significant milestone for Cotiviti and one that positions us for continued growth across the healthcare ecosystem as we leverage our deep expertise and infrastructure,” said Emad Rizk, M.D., Chairman, President, and CEO of Cotiviti. “In Veritas and KKR, we have two world-class investment firms joining forces because of their belief in our mission