Payment Integrity Audit Coordinator

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 waste, fraud and abuse. Codoxo is 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 ensure payment integrity.

Codoxo helps 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 proven

Forensic AI Engine, which uses patented AI-based technology to identify problems 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 Audit Coordinator is an operational role within the Data Mining team, supporting the day-to-day execution of payment integrity audit programs across Codoxo’s client accounts.

This role is responsible for the operational groundwork that keeps audit workflows running smoothly — including audit setup and triage, audit queue management, correspondence coordination, and delivery support. The Payment Integrity Audit Coordinator works under the direction of the Data Mining Manager and the Data Mining Analysts, following established processes and SOPs to ensure accurate, timely, and organized audit operations.

Key Responsibilities

Audit Setup & Triage Support

• Assist in the setup and configuration of new audit workflows within the Codoxo platform under manager, analyst or client direction.
• Triage audit queues by organizing, sorting, and routing according to established priority rules and concept specifications.
• Track case volumes and queue status, flagging backlog issues or routing errors to manager.
• Maintain accurate records of audit activity, assignments, and workflow status in designated tracking systems.

Correspondence & Mailing Coordination

• Coordinate the preparation and distribution of audit-related correspondence, including overpayment demand letters and provider notifications.
• Ensure mailings are completed accurately, on schedule, and in compliance with client-specific requirements.
• Track correspondence status and maintain logs of outbound communications.
• Support the collection and organization of provider responses and supporting documentation.

Operational & Administrative Support

• Assist Data Mining Analysts with the preparation of client-facing deliverables, including report compilation and document formatting.
• Maintain organized file structures, shared drives, and documentation repositories for audit materials.
• Participate in team meetings and contribute to process improvement discussions.

Cross-Functional Coordination

• Serve as a reliable operational point of contact for routine coordination tasks between Data Mining, Customer Success, and other internal teams.
• Communicate clearly and professionally regarding task status, deadlines, and escalation needs.
• Follow all established SOPs and escalate process gaps or ambiguities promptly.

Qualifications

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Business, Health Information, or a related field preferred.
• At least 1–2 years of experience in a healthcare, administrative, or operational support role.
• Strong organizational skills and attention to detail.
• Ability to manage structured, repetitive tasks accurately and efficiently.
• Comfortable working in a fast-paced environment with defined processes and deadlines.
• Basic proficiency in Microsoft Office Suite, particularly Excel, Word, and Outlook.
• Strong written and verbal communication skills.

Preferred Qualifications

• Prior exposure to health plan operations, healthcare claims, or payment integrity environments.
• Experience with case tracking systems, audit platforms, or document management tools.
• Familiarity with healthcare terminology, claim types, or billing processes is a plus but not required.

Technical Skills

• Proficient in Microsoft Office Suite (Excel, Word, Outlook)
• Experience with document management or case tracking platforms is a plus
• Familiarity with Confluence, Jira, or SharePoint is desirable but not required

Core Competencies

• Organization & Attention to Detail
• Workflow & Queue Management
• Correspondence Coordination
• Process Adherence
• Team Collaboration
• Written & Verbal Communication
• Reliability & Accountability

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 computer, operate standard office equipment, and work at a desk.

Accessibility Notice

If you need reasonable accommodation for any part of the employment process due to a physical or mental disability, please send an email to careers@codoxo.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

Codoxo provides 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, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment.