Technical Customer Solutions Manager

Posted 7hrs ago

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Job Description

Technical Customer Solutions Manager fostering client success by leveraging Cotiviti products. Leading relationship management and operational expertise in healthcare payer landscape.

Responsibilities:

  • 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