Payment Integrity Analytics Consultant

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

We are seeking a highly analytical Payment Integrity Analytics Consultant focused on designing and implementing detection logic across healthcare claims datasets. This role is execution-oriented and will play a foundational role in building, validating, and refining production-grade payment integrity detections and systems.

The ideal candidate thrives in structured problem spaces, takes pride in technical rigor, and is comfortable working deeply within complex datasets to produce high-quality, scalable logic.

Core Responsibilities

Design, implement, and validate advanced detection logic
Translate SME concepts into precise, scalable rule definitions
Ensure detection accuracy through edge case evaluation and rigorous validation
Troubleshoot anomalies in detection outputs
Identify and implement workflow improvements to reduce rework and improve efficiency
Collaborate with domain SMEs and engineering to ensure successful deployment

Required Qualifications

4+ years of experience in analytics engineering, data-intensive application development, detection development, or related technical roles
Advanced SQL proficiency (including window functions, complex joins, performance optimization)
Strong programming skills in Python or a similar general-purpose language (e.g., Java, Scala), applied to data processing and automation
Experience working with large structured datasets
Strong logical reasoning and ability to decompose complex problems
Demonstrated ability to work autonomously within defined objectives
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

Experience working with healthcare claims data
Familiarity with payment integrity or fraud detection concepts
Experience working in cloud platforms (e.g., AWS, Azure, GCP)

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.

Apply for this job

First name

Last name

Email address

Location

Phone number

Resume

Attach resume

Attach another file

Attach file

What is your Linkedin Profile URL?

What are your salary requirements?

What is your earliest start date?

How are you authorized to work in the US?

We invite you to complete the optional self-identification questions below used for compliance with government regulations and record-keeping guidelines. Any self-identification information provided will not be considered in the selection process.

GENDER

VETERAN STATUS Learn more about veteran statuses

If you believe you belong to any of the categories of protected veterans listed below, please indicate by selecting the appropriate category(ies). The hiring employer is subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA) and requests this information in order to measure the effectiveness of the outreach and positive recruitment efforts it undertakes pursuant to VEVRAA.

DISABILITY STATUS Learn more about disability statuses

We are required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.