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

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:  

As Sr. Product Manager-Payment Integrity, you’ll be responsible for managing Payment Integrity products built on top of the core Codoxo forensic AI and Generative AI platform. Additionally, the Sr. Product Manager will own and drive the strategy, roadmap, and execution for our Payment Integrity product suite. 

 

This is a high-impact role at the intersection of healthcare domain expertise, AI-powered product innovation, and SaaS product management. You will work across multiple audit types, collaborate closely with subject matter experts, and partner with engineering and data science teams to deliver products that scale across customers. 

The right candidate has lived the payment integrity workflow - whether as an auditor, claims operations leader, or product manager at a payment integrity vendor - and has the product management discipline to translate that knowledge into configurable, scalable SaaS products. 

 

Codoxo is rapidly expanding its core forensic AI and Generative AI platform to support multiple payment integrity products and workflows. You will work with engineering, data science and Codoxo’s Audit and Payment Integrity analysts to create a vision and own the roadmap for payment integrity products. You’ll also be working closely with customers to better understand their Payment integrity workflows and implement them on the core Codoxo platform. 

 

Key Responsibilities: 

  • Own the product roadmap for Data Mining and Complex Claim Audit management products  

  • Lead customer discovery with health plan audit teams, claims operations leaders, and clinical reviewers - going beyond surface-level requests to uncover generalizable workflow needs 

  • Define product requirements across audit types (e.g., DRG validation, clinical validation, itemized bill review, data mining concepts), identifying common platform patterns while accounting for audit-type-specific logic 

  • Shape the GenAI-powered medical record review experience, making critical product decisions about what to automate, where human judgment is essential, and how to design auditor-in-the-loop workflows 

  • Collaborate with engineering and data science teams to deliver high-quality products, providing the domain context they need to build effectively 

  • Partner with clinical SMEs and auditors to validate requirements, test assumptions, and ensure domain accuracy 

  • Drive go-to-market readiness working with sales, marketing, and implementation teams on positioning, enablement, and launch 

  • Make principled trade-off decisions - resisting one-off customization requests in favor of scalable, configurable product solutions that serve the broader market 

  • Manage the Codoxo Payment Integrity products and ensure they meet the defined success metrics  

  • Work closely with Codoxo data science, product engineering, customers, customer success, and Codoxo payment integrity experts to define and execute the roadmap for payment integrity products  

  • Support product marketing to create content for internal and external stakeholders 

 

Qualifications: 

  • Bachelor's in Engineering, Computer Science, technical related field, or equivalent practical experience 

  • 5+ years of professional experience in payment integrity, claims auditing, or claims operations - as a product manager, auditor, audit manager, solutions architect, or operations leader 

  • 3+ years in a Product Management role at a B2B SaaS or healthcare technology company, with direct ownership of roadmap, backlog, and delivery working alongside engineering teams 

  • Working knowledge of multiple audit types with an understanding of how claims are identified for audit, how medical records are reviewed, and how findings are documented and recovered 

  • Experience building or contributing to products that scale - you can point to examples where you turned domain-specific knowledge into configurable, platform-level product capabilities rather than customer-specific features 

  • Comfort working with AI/ML-powered products - you don't need to be a data scientist, but you can reason about automation vs. human review trade-offs, provide feedback on model outputs, and design workflows where AI and human expertise complement each other 

  • Strong customer discovery and stakeholder management skills - you can lead a conversation with a VP of Payment Integrity and an audit nurse with equal confidence, and translate what you learn into clear product direction 

  • Proven experience in gathering and prioritizing product requirements into a meaningful product roadmap 

  • Experience with Agile software methods 

  • A learning and growth mindset with an ability to self-start on problems, a willingness to own problems, and a desire to make things better 

  • You must demonstrate a strong product sense and have experience working with design teams   

  • You can lead without giving orders and argue a viewpoint persuasively 

  • You can write, speak, and think about complicated and highly technical problems with lucidity 

  • 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.  

 

Preferred Qualifications 

  • Prior hands-on operational experience in claims or auditing before transitioning to a product or technology role - former auditors, audit team leads, or claims operations managers who moved into product bring invaluable workflow intuition 

  • Experience managing products at different lifecycle stages simultaneously - maintaining and growing a mature product while launching a new one 

  • Familiarity with clinical documentation, medical coding, and classification systems (ICD-10, CPT, DRG grouping, medical record abstraction) 

  • Understanding of health plan IT ecosystems - claims adjudication platforms, EDI transactions (835/837), provider data, and how audit workflows integrate with core administrative systems 

  • Experience working directly with data science or machine learning engineering teams on products that involve model-generated outputs reviewed by human users 

  • Prior experience with analytics, healthcare payment integrity or revenue cycle management products is a plus 

  • Proven record of product management accomplishments with demonstrated market success 

 

 

Accessibility Notice: If you need reasonable accommodation for any part of the employment process due to a physical or mental disability, please send and 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) 

 

We are an 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.