Full-Time

Principal AI Engineer

Risk Adjustment Coding Agent

Deadline 8/12/27
Cotiviti

Cotiviti

1,001-5,000 employees

Healthcare payment accuracy analytics provider

Compensation Overview

$208k - $260k/yr

+ Discretionary bonus

Remote in USA

Remote

Bachelor's, Master's

Category
AI & Machine Learning (1)
Required Skills
Kubernetes
MLOps
Microsoft Azure
Python
Distributed Systems
Java
MLflow
Docker
Microservices
AWS
LangGraph
LangChain
Databricks
Google Cloud Platform

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Requirements
  • A Bachelor's or Master's degree in Computer Science, Engineering, or a related field is required.
  • At least 12 years of software engineering experience, including at least 2 years working on AI/ML platforms or infrastructure, is required.
  • Experience building large-scale distributed systems and microservices is required.
  • Strong programming skills in Python and Java are required.
  • Hands-on experience with agentic AI frameworks such as LangChain, LangGraph, CrewAI, AutoGen, or similar is required.
  • Experience with containerization and orchestration using tools such as Docker and Kubernetes is required.
  • Understanding of MLOps tools such as MLflow, Kubeflow, SageMaker, Vertex AI, or Databricks is required.
  • Cloud platform experience with AWS, GCP, or Azure is required.
  • The ability to navigate complex, ambiguous, and fast-changing technologies and requirements is required.
  • The ability to work independently and collaborate with global and geographically dispersed teams is required.
  • Professional handling of confidential information is required.
  • The ability to handle multiple tasks, prioritize, and meet deadlines is required.
  • The candidate must provide high-speed internet access or connectivity and maintain an office setup.
  • The candidate must provide a dedicated, secure work area.
Responsibilities
  • Design and implement scalable agentic solutions for diverse use cases.
  • Leverage open-source AI technologies to build and maintain a centralized AI platform with unified APIs for cross-functional team access and build various types of agents.
  • Work with Product Engineers to integrate AI agents into customer-facing applications and internal tools.
  • Lead technical discussions, mentor junior engineers, and help set the technical vision for the AI platform roadmap.
  • Ensure compliance with security, privacy, and regulatory requirements across the software development lifecycle.
  • Optimize the performance of AI-powered workloads across compute and storage layers using cloud-native and open-source solutions.
  • Conduct performance analysis and capacity planning to ensure platform scalability.
  • Complete 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.
Desired Qualifications
  • Experience in Risk Adjustment coding.

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

  • Cotiviti launched AI-enabled dental claim accuracy on August 4, 2026.
  • Cotiviti certified all NCQA Digital HEDIS measures on June 2, 2026.
  • Ric Sinclair’s March 16, 2026 CEO appointment signals a new growth phase.

What critics are saying

  • Bloomberg and Axios said Cotiviti’s debt reached roughly $7 billion after Edifecs.
  • KKR and Veritas control Cotiviti, forcing exit pressure over product investment timing.
  • Any failed Edifecs integration undermines interoperability claims and weakens the platform story.

What makes Cotiviti unique

  • Cotiviti’s 2026 Proactive COB shifts payment integrity upstream at enrollment.
  • Its Edifecs acquisition deepens interoperability, risk adjustment, and pre-payment workflows.
  • Everest Group named Cotiviti a 2026 market-impact leader for pre-payment integrity.

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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

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.

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.