Payment Integrity Engineer

Codoxo is a leading provider of artificial intelligence-driven solutions aimed at reducing fraud, waste, and abuse in healthcare. The Payment Integrity Engineer will design and implement detection logic across healthcare claims datasets, ensuring the accuracy and efficiency of payment integrity detections and systems.

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

Requirements:

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