Lead and oversee Provider Scope operations and education services to detect fraud, waste, and abuse in healthcare claims. Collaborate with cross-functional teams to implement operational processes and serve as the primary expert contact for customers.
Codoxo
10 Remote Job Openings at Codoxo
The role involves running AI analytical reports and managing automation scripts using AWS Airflow. Additionally, the engineer will monitor AWS infrastructure health and create data visualizations in AWS QuickSight.
Perform medical claim audits to identify overpayments by reviewing billing, coding policies, and regulatory requirements. Collaborate with AI teams to translate clinical and regulatory needs into audit models and deterministic logic.
Design and operate agentic AI products to automate healthcare claim audits and SIU investigations. Build serverless architectures on AWS using Bedrock AgentCore and orchestrate multi-agent plans with Strands.
The role acts as a bridge between customer success and product management to support Payment Integrity SaaS solutions and client adoption. Key duties include translating client needs into technical specifications, supporting data mining operations, and documenting product requirements.
The role involves expanding and curating high-quality ground truth datasets of SIU cases and claims to improve AI detection models. The analyst will also provide feedback on GenAI tools and validate the realism of synthetic healthcare data.
The role supports the day-to-day execution of payment integrity audit programs, focusing on audit setup, triage, and queue management. It also involves coordinating audit-related correspondence and assisting analysts with client-facing deliverables.
Perform detailed medical record and coding reviews to validate DRG assignments and ensure appropriate reimbursement. Identify coding inaccuracies and documentation gaps to support payment integrity and recover improper payments.
The Client Implementation Director manages the planning, scoping, and delivery of AI solutions to healthcare clients to maximize value. This includes managing project risks, facilitating executive business reviews, and implementing process improvements.
Own the strategy, roadmap, and execution for an AI-powered Fraud, Waste, and Abuse detection platform. Lead the transition toward agentic AI workflows to automate lead triage and evidence gathering for healthcare investigators.
