Payment Integrity Audit Coordinator

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, mailroom operations, medical record intake, document management, and delivery support. The Payment Integrity Audit Coordinator works under the direction of the Data Mining Manager and Data Mining Analysts, following established processes and standard operating procedures (SOPs) to ensure accurate, timely, and organized audit operations. As the primary coordinator for incoming audit correspondence and medical records, this role also manages the receipt, tracking, scanning, organization, and distribution of physical documentation critical to payment integrity investigations. 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 cases according to established priority rules and concept specifications. Handle audit file submissions to the client and the associated exception handling Track case volumes and queue status, identifying backlog issues or routing errors and escalating as appropriate. Maintain accurate records of audit activity, assignments, and workflow status within designated tracking systems. Mailroom Operations & Medical Record Management Receive, sort, and distribute incoming mail, packages, and audit-related correspondence. Process incoming medical records from providers, ensuring documents are accurately logged, date-stamped, scanned, indexed, and uploaded into appropriate systems. Maintain chain of custody and accurate inventory of physical medical records and audit documentation. Organize and manage physical and electronic document repositories, ensuring records are easily retrievable and maintained according to retention policies. Coordinate secure storage, filing, and disposal of confidential healthcare records in accordance with HIPAA and company policies. Monitor incoming document volumes and ensure timely processing to support audit deadlines. Coordinate outbound shipping of audit materials and provider correspondence as needed. Correspondence & Mailing Coordination Prepare, assemble, and distribute audit-related correspondence, including overpayment demand letters, provider notifications, and client communications. 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, organization, and routing 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, document repositories, and audit records. Monitor inventory of mailing and office supplies related to audit operations and coordinate replenishment when needed. Participate in team meetings and contribute to continuous process improvement initiatives. Cross-Functional Coordination Serve as a reliable operational point of contact for routine coordination between Data Mining, Customer Success, Operations, and other internal teams. Communicate clearly and professionally regarding task status, processing timelines, and escalation needs. Follow established SOPs and proactively identify opportunities to improve operational efficiency. Qualifications High school diploma or equivalent required; Associate's or Bachelor's degree in Healthcare Administration, Business, Health Information Management, or a related field preferred. 1–2 years of experience in healthcare operations, administrative support, records management, mailroom operations, or a related operational role. Strong organizational skills with exceptional attention to detail. Ability to manage structured, repetitive workflows with accuracy and efficiency. Comfortable handling confidential healthcare information in accordance with HIPAA requirements. Ability to prioritize multiple tasks while meeting deadlines in a fast-paced environment. Proficiency with Microsoft Office Suite, particularly Excel, Word, and Outlook. Strong written and verbal communication skills. Preferred Qualifications Experience working in healthcare payment integrity, health plan operations, claims processing, or medical records management. Experience receiving, scanning, indexing, and managing large volumes of documentation. Familiarity with document management systems, case tracking platforms, or imaging software. Knowledge of healthcare terminology, claim types, medical records, or billing processes. Experience working with physical records inventory and document retention procedures. Technical Skills Microsoft Office Suite (Excel, Word, Outlook) Document imaging and scanning systems Document management or case tracking platforms SharePoint, Confluence, or Jira (preferred but not required) 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 View email address on click.appcast.io 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. #J-18808-Ljbffr Codoxo