Cotiviti is a healthcare analytics and technology company that works with healthcare payers, providers, government entities, and retailers - including some of the largest health plans and Fortune 1000 companies in the United States. Its core focus is helping these organisations reduce costs and improve care quality through data analytics and AI-powered platforms.
The company's proprietary analytics platforms use artificial intelligence and machine learning across a broad set of use cases, including payment integrity, risk adjustment, clinical chart validation, HEDIS and Star Ratings optimisation, and member and consumer engagement. These solutions are designed to identify improper payments, support accurate risk adjustment, and improve financial and clinical performance for clients operating at scale.
Cotiviti recently expanded its capabilities through the acquisition of Edifecs, a move that adds healthcare data interoperability to its existing portfolio. The combined offering covers the intersection of payment accuracy, quality measurement, clinical documentation, and data exchange - areas that increasingly require tight integration as healthcare organisations face growing regulatory and operational complexity.
Technical work at Cotiviti spans data analytics, machine learning, AI, and interoperability engineering, applied within a domain that demands both rigour and scale. The company has decades of experience in healthcare analytics and continues to invest in developing its technology platforms.