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
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As a Business Analyst at Codoxo, you will support the successful onboarding, validation, and analysis of healthcare claims data within our platform. You will work closely with customers, implementation teams, data engineers, and product stakeholders to ensure data quality, document business requirements, and assist with data mapping and reporting activities.
This role is ideal for someone with experience working with healthcare data who enjoys problem-solving, analyzing data, and collaborating across teams to deliver high-quality solutions.
Key Responsibilities
Healthcare Data Analysis
Leverage your understanding of healthcare claims, provider, and member data.
Analyze professional, facility, pharmacy, and dental claims data to identify trends, gaps, and inconsistencies.
Leverage knowledge of healthcare coding systems, including ICD-10, CPT, HCPCS, and DRG.
Support analysis of pre- and post-adjudicated claims data.
Understand claim adjustment logic and its application.
Assist with maintaining accuracy, consistency and integrity of healthcare claims, provider and member data
Data Validation & Quality Assurance
Review customer-supplied data for completeness, quality, and compliance with platform requirements.
Validate data after ingestion into the platform to ensure accuracy and reliability.
Identify and document data quality issues and work with internal teams to resolve them.
Assist in maintaining data mappings and transformation documentation.
Requirements Gathering & Documentation
Gather and document business and data requirements from internal and external stakeholders.
Create and maintain process documentation, data dictionaries, and mapping specifications.
Document findings, recommendations, and project updates.
Support testing and validation activities for new implementations and enhancements.
Reporting & Analysis
Assist in creating customer-facing reports and internal analytical deliverables.
Perform data analysis to identify patterns, anomalies, and opportunities for improvement.
Support ongoing monitoring of data health and platform performance.
Cross-Functional Collaboration
Partner with Product, Engineering, Customer Success, and Data Operations teams to support customer implementations.
Participate in customer meetings and assist in gathering information and resolving issues.
Provide regular status updates on assigned projects and deliverables.
Technical Skills
Utilize Excel and Office 365 tools for data analysis and reporting.
Write and execute SQL queries to analyze and validate data.
Support automation and process improvement initiatives where applicable.
Qualifications
Required
Bachelor's degree in Business, Healthcare Administration, Information Systems, Data Analytics, or a related field.
5+years of experience as a Business Analyst, Data Analyst, or related role.
Experience working with healthcare claims, provider, or member data.
Basic understanding of healthcare claims processing and payment workflows.
Experience gathering and documenting business requirements.
Proficiency with Microsoft Excel and Office 365.
Experience writing SQL queries.
Strong analytical, problem-solving, and organizational skills.
Excellent written and verbal communication skills.
Strong attention to detail and commitment to data quality.
Preferred
Experience with healthcare payment integrity, fraud, waste, and abuse programs.
Familiarity with SaaS applications and implementation projects.
Experience with healthcare coding systems (ICD-10, CPT, HCPCS).
Exposure to SQL, Python, Power BI, Tableau, or similar analytical tools.
Remote Work Requirements: To ensure reliable performance on the company-issued CODOXO laptop, employees working remotely must have a stable high-speed internet connection. Internet performance should be measured using a speed test conducted directly on the CODOXO laptop, not based solely on the internet plan purchased from the provider.
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 [email protected] 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
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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.