COTIVITI INC

Cotiviti Inc. specializes in recovery audit and claims integrity services for federal health programs, leveraging advanced data analytics and compliance monitoring to identify improper payments and enforce financial accountability. Their core capabilities include forensic claims analysis, fraud detection algorithms, and audit workflow automation tailored to Medicare and Medicaid systems. The contractor applies deep domain expertise in healthcare reimbursement rules, payer-provider reconciliation, and regulatory compliance frameworks to support audit operations that recover taxpayer funds while ensuring program integrity. Their technical proficiency spans claims data mining, exception reporting, and audit trail documentation, with a focus on scalable, rules-based systems that adapt to evolving CMS guidelines and federal auditing standards. Cotiviti Inc. has established a consistent relationship with the Department of Health and Human Services, delivering recovery audit services under specific regional and programmatic mandates. Their engagements center on identifying overpayments and underpayments within federal health benefit programs, supporting HHS offices in enforcing payment accuracy and reducing financial leakage. This sustained partnership indicates a trusted role in operationalizing audit directives and providing actionable insights to program integrity divisions. The contractor’s primary industry focus is on collection agencies under NAICS 561440, which in federal contracting translates to specialized financial recovery and claims validation services within the healthcare sector. They occupy a niche position as a technical service provider in government healthcare finance, distinct from general collections firms by their focus on complex reimbursement systems and regulatory compliance. Cotiviti Inc. is structured as a 2L entity headquartered in South Jordan, Utah, with no public certifications listed. Their geographic presence is centered in the western U.S., and they operate as a focused contractor within the federal health finance ecosystem, providing specialized audit and recovery services without broad-scale certification credentials.