Remote Claims Processor Jobs in Fayetteville, AR

The Cotiviti Retail Business Process Optimization (BPO) Team is seeking a Manager to work closely with our operations, R&D, and client teams.  We are looking for an individual who is a self-starter, interested in developing their own skills and experiences as well as being a trusted go-to resource for other BPO team members.  We are looking for an individual who is technically sound but also curious and interested in learning our unique and results oriented business.  This individual must possess a complete understanding of retail audit recovery work, best practices for managing audit teams, great interpersonal skills and be comfortable with conducting presentations.  Experience with BI tools in translating data into meaningful and inciteful visualizations is a must.

Responsibilities

• Identify opportunities for improvement in Current Cotiviti Audit processes.
• Help Cotiviti audit teams maximize resources and drive top end revenue and bottom-line margin growth.
• Utilize BI tools to enhance and support existing reporting/data warehouse environment, including use of SQL Management Studio, Power BI and Tableau, Excel, MS Access.
• Support the Retail/Cotiviti management and other stakeholders in evaluating, defining, standardizing, and reporting on key KPI's to drive financial evaluation and performance.
• Manage development lifecycle of report generation (development, test/QA, UAT, bug fix/retest cycles)
• Ensure proper documentation and training materials
• Provide expertise for the design and requirements for both executive and client facing reports, scorecards, and dashboards.
• Lead collaborative conversations with client teams to drive stickiness and growth opportunities
• Field and provide support for ad hoc data analysis requests/recommendations from Retail management others on the leadership team
• Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction.

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 the requirements of the job change.

Qualifications

• Bachelor’s degree in Business, Accounting, Computer Science, Information Management, or related field.
• 8+ years of audit and management experience in the Retail space.
• 8+ years claims recovery lifecycles and expertise with financial forecasting.
• 8+ years with working with retail client data and translating to audit tools and optimized workflows.
• 2+ years direct work experience with Microsoft Power BI and SSRS and data modeling.
• 1 year direct work experience with Microsoft Tableau.
• Ability to document technical requirements for business processes and development needs.
• Expert in SQL programming, database structures and schemas.
• Demonstrated and proven project management skills.
• Strong attention to detail and accuracy.
• Ability to work independently and remotely with minimal supervision.
• Superior analytical and problem-solving skills.
• Ability to effectively communicate and collaborate with internal and external stakeholders with a customer service focus and mindset.

Mental Requirements:

• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
• No adverse environmental conditions expected.

Base compensation ranges from $148,000 to $189,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. 

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: 7/9/2026

Applications are assessed on a rolling basis. We anticipate that the application window will close on 9/9/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

Cotiviti is an equal employment opportunity employer. Cotiviti recruits, hires and promotes individuals based on their qualifications for a specific job. Selection of employees is made without regard to race, color, creed, sex, age, religion, pregnancy or pregnancy-related conditions, national origin, sexual orientation, gender identity, marital status, genetic carrier status, military service, veteran status, uniformed service member status, disability, or any other category of class protected by federal, state or local laws. All employment decisions and personnel actions, such as hiring, promotion, compensation, benefits, and termination, are and will continue to be administered in accordance with, and to further the principle of, equal employment opportunity.
Pay Transparency Nondiscrimination Provision
Cotiviti will not discharge or in any manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-I.35(c)

Cotiviti is a leading solutions and analytics company that leverages unparalleled clinical and financial datasets to deliver deep insight into the performance of the healthcare system. These insights uncover new opportunities for healthcare organizations to collaborate to improve their financial performance, reduce inefficiency, and improve healthcare quality.

We focus on improving the financial and quality performance of our clients. In healthcare, this means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality. In addition, we support retail and life/legal industries with data management and recovery audit services.

Cotiviti applies deep data science and market expertise to help healthcare organizations in three critical areas:

• Payment Accuracy: analyzing data flowing between payers and providers to ensure that claims are paid appropriately
• Risk Adjustment: ensuring that health plans accurately capture and report how sick their members are so that plans are appropriately reimbursed for the healthcare services their members receive
• Quality and Performance: evaluating healthcare cost, quality, and utilization at individual, provider, and population levels to identify the best opportunities for financial and clinical performance improvement