Technical Customer Solutions Manager

🕒 April 11

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Cotiviti

5001 - 10000 employees

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Develop, implement, and complete tactical project plans related to customer issue resolution, quality improvement plans, and program enhancements. • Act as the lead relationship manager for assigned accounts, coordinating proactive customer communication and cross-functional collaboration. • Lead customers to success by understanding their business needs and aligning Cotiviti software and services to drive high-impact results. • Partner with Account and Product Management on Customer Health, NPS, Executive Business Reviews (EBRs), Expansion, and Renewals by delivering against assigned KPIs. • Forecast and track operational metrics including member volumes, encounter throughput, revenue recognition, and submission accuracy. • Apply deep operational knowledge of CMS regulations and audit frameworks to ensure accurate, compliant processing. • Leverage your expertise in encounter submissions and EDI transactions (834, 837, 835, 270/271) to support client success and issue remediation. • Analyze client support tickets and product issues to identify systemic trends and advocate for internal resolution. • Serve as a key conduit for customer enhancement requests through structured feedback loops to Product Management. • Ensure all contracted deliverables are provided accurately, on schedule, and in alignment with client expectations. • Complete all responsibilities as outlined in the annual performance review and/or goal setting. • Complete all special projects and other duties as assigned. Must be able to perform duties with or without reasonable accommodation.

🎯 Requirements

• Master’s Degree OR a minimum of 6 years of relevant experience. • 6+ years of deep operational knowledge of data integration systems including in claim processing systems like FACETS, QNXT, SAP ECC, OR Cotiviti/Edifecs like platforms. • 6+ years of technical expertise in claims processing, encounter submissions, and risk adjustment workflows. • Fluent in Software as a Service (SaaS) distribution models. • 6+ years of Proven success in healthcare or related technical field. • Familiarity with customer journey mapping and strategic success planning. • Strong working knowledge of Microsoft Office, Freshdesk, SQL, and Jira.

🏖️ Benefits

• medical, dental, vision, disability, and life insurance coverage • 401(k) savings plans • paid family leave • 9 paid holidays per year • 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti

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