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

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

data integration systemsclaims processingencounter submissionsrisk adjustment workflowsoperational metricscustomer journey mappingstrategic success planningKPI trackingEDI transactionsCMS regulations

Soft Skills

relationship managementcross-functional collaborationcustomer communicationproblem-solvingadvocacyproject managementanalytical skillsattention to detailorganizational skillsleadership

Certifications

Master’s Degree