Payment Integrity Business Analyst
Jobs at Codoxo
Payment Integrity Business Analyst Your City Your State Category Customer Success Type Full-time Min. Experience Some Experience
PLEASE NOTE BEFORE APPLYING CODOXO IS NOT ABLE TO OFFER SPONSORSHIP OR ACCOMMODATE ANY CANDIDATES THAT ARE CURRENTLY BEING SPONSORED NOW OR IN THE FUTURE
About Codoxo Of the 3.8T we spend on healthcare in the United States annually about a third of it is estimated to be lost due to wastefraudand abuse. Codoxois the premier provider of artificial intelligence-driven solutions and services that help healthcare companies and agencies proactively detect and reduce risks from fraud waste and abuse and ensurepaymentintegrity. Codoxohelps clients manage costs across network management clinical care provider coding and billing payment integrity and special investigation units. Our software-as-a-service applications are built on our provenForensic AI Engine which uses patented AI-based technology toidentifyproblems and suspicious behavior far faster and earlier than traditional techniques. We are venture backed by some of the top investors in the country with strong financials and remain one of the fastest growing healthcare AI companies in the industry.
Position Summary The Payment Integrity Business Analyst sits within the Customer Success Team and will play a key role in supportingCodoxosPayment Integrity SaaS solutions and ensuringsuscessfulclient adoption and operational value. This role serves as a bridge between customer success teams and product management helping translate customer needs into actionable insights enhanced workflows and platform enhancements. The Payment Integrity Business Analyst will support client implementations assist in the operationalization of in-house data mining concepts and help document design and submit tickets for new product capabilities. This role requires a strong understanding of healthcare claims data payment integrity workflows and healthcare reimbursement methodologies. The ideal candidate is a highly motivated problem solver with strong analytical ability excellent communication skills and experience working with healthcare claims data and analytics platforms.
Key Responsibilities
Customer Success & Client Engagement Support Customer Success teams in the implementation and optimization of Codoxo Payment Integrity SaaS solutions. Assist clients in understanding platform capabilities and analytical outputs. Help translate client and internal business needs into platform configuration requirements and operational workflows. Participate andor lead client meetings demonstrations and solution reviews.
Data Mining Operations Support Collaborate with internal data mining teams to support the identification and development of new Payment Integrity concepts and system functionality. Assistwith documentation of analytical methodologies and audit specifications. Support the operationalization of data mining concepts into scalable workflows within theCodoxoplatform. Validate data outputs andassistwith the preparation of client-facing deliverables.
Product Development & Platform Enhancements Gather and document business requirements for new platform capabilities and enhancements. Work closely with product and engineering teams to translate operational needs into technical specifications. Assistproductmanagementbacklog development user story creation and prioritization of product features. Support user acceptance testing UAT for new platform functionality.
Cross-Functional Collaboration Act as a liaison between Customer Success Data Mining Product and Engineering teams. Document workflows operational processes and product requirements. Proactivelyidentifyopportunities to improve product usability automation and analytical workflows.
Qualifications Bachelors degree in Business Healthcare Administration Data Analytics Information Systems or relatedfield. 3 years of experience working with healthcare claims data payment integrity healthcare analytics or health plan operations. Strong understanding of healthcare claims including CPT HCPCS and ICD-10 coding structures. Experience analyzing healthcare claims data or supporting Payment Integrity programs. Strong analytical and problem-solving skills.
Preferred Qualifications Experience working with Payment Integrity programsincluding butnot limitedtocaseaudit tracking software analytic capabilities edits rules fraud waste and abuse detection. Experience supporting healthcare SaaS platforms or analytics tools. Familiarity with SQL PythonPowerBI Tableauor other data analysisquery tools. Knowledge of Medicare Medicaid and Commercial reimbursement methodologiesand audit capabilities.
Technical Skills Proficient in Microsoft Office Suite Experience with data analytics tools or SQL-based environments preferred Familiarity withConflluenceJira SharePoint and AWSisdesirable
Physical Requirements Work is performed in an office environment either in our office or work-from-home and requires the ability to work on a computeroperatestandard office equipment and work at a desk. If you need reasonable accommodation for any part of the employment process due to a physical or mental disability please send an email to careerscodoxo.com with the subject Accommodation. Reasonable accommodation requests will be considered on a case-by-case basis.
Benefits for You Health Dental and Vision insurance with 100 employee premium coverage Starts Day 1 Unlimited PTO Annual Professional Development stipend Annual home office stipend 401K Match after 90 days
Equal Opportunity Employer Codoxoprovides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex