Technical Customer Solutions Manager

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.

Qualifications

• 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.
• Excellent organizational, communication, and interpersonal skills with a client-first approach.