Job Description

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. 

Summary:

We are seeking a talented and motivated Generative AI Data Scientist with a focus on Healthcare Payment Integrity to join our team. As a Generative AI Data Scientist in the field of healthcare payment integrity, you will be responsible for developing and implementing advanced generative AI models to enhance payment integrity processes, detect fraud, waste, and abuse, and improve accuracy and efficiency in healthcare payment validation.

Responsibilities:

·      Develop and implement generative AI models tailored for healthcare payment integrity, using techniques such as generative adversarial networks (GANs), variational autoencoders (VAEs), or other relevant architectures.

·      Leverage generative AI models to identify patterns, anomalies, and suspicious activities in healthcare payment data, with a focus on fraud detection, claim validation, and risk assessment.

·      Preprocess and analyze healthcare payment data, applying data augmentation, normalization, and feature engineering techniques to optimize model training and performance.

·      Collaborate with payment integrity teams, data engineers, and domain experts to understand specific payment integrity requirements and design AI solutions that address fraud, waste, and abuse issues effectively.

·      Stay updated with the latest research and advancements in generative AI for healthcare, adapting and applying relevant methodologies to improve payment integrity processes.

·      Evaluate and validate the performance of generative AI models using appropriate metrics and statistical analysis, ensuring their accuracy, reliability, and applicability in healthcare payment integrity.

·      Address ethical considerations and privacy concerns in the development and deployment of generative AI models for healthcare payment integrity, ensuring compliance with regulatory requirements and protecting patient and provider information.

·      Document methodologies, experiments, and findings to support transparency, reproducibility, and knowledge sharing within the organization.

·      Stay informed about industry trends, emerging technologies, and best practices related to healthcare payment integrity and generative AI, identifying opportunities for innovation and process improvement.

Qualifications:

·      Master's or Ph.D. degree in Computer Science, Data Science, Healthcare Informatics, or a related field.

·      Strong knowledge of machine learning concepts and techniques, with a focus on generative models and deep learning architectures relevant to healthcare payment integrity.

·      Proficiency in programming languages such as Python and experience with deep learning frameworks (e.g., TensorFlow, PyTorch, Keras) for developing and training generative AI models.

·      Experience working with large-scale healthcare datasets, including data preprocessing, data quality assessment, and data manipulation techniques.

·      Strong analytical and problem-solving skills, with the ability to interpret complex patterns and anomalies in healthcare payment data.

·      Excellent communication skills to collaborate effectively with cross-functional teams and present findings to both technical and non-technical stakeholders.

Preferred Qualifications:

·      Solid understanding of healthcare payment data, healthcare claim processes, and the regulatory landscape surrounding healthcare payment integrity.

·      Previous experience or familiarity with healthcare payment integrity, fraud detection, or healthcare claims processing.

·      Experience with advanced generative AI techniques beyond GANs and VAEs, such as flow-based models or attention mechanisms, and their application in healthcare.

·      Solid understanding of healthcare payment data, healthcare claim processes, and the regulatory landscape surrounding healthcare payment integrity.

·      Experience in extracting, transforming, and analyzing healthcare payment data using Python and Pandas, including data preprocessing, data cleansing, and feature engineering.

·      Experience with version control systems, such as Git, for collaborative development and code management in a team environment.

Join our dedicated team and apply your expertise in generative AI to make a significant impact in healthcare payment integrity, combat fraud, and ensure the accuracy and integrity of healthcare payments. Together, we can drive innovation and enhance the financial sustainability of healthcare systems.

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.