payment-integrity

Medicare Part B payment integrity analysis: 10 SQL prepayment edits route 96% of claims without manual review, cutting decision cost 72% ($425K to $120K). Python, PostgreSQL, Power BI.

Read-only payment integrity monitoring for WooCommerce agencies: reconcile Stripe payments, orders, and refunds with reproducible evidence.

Cotiviti intern assessment — three-era clinical NLP (rules → LLM → vision): measured 89%→100% status accuracy, validated on real de-identified notes, ICD-10-CM guardrails + audit trail

Apixio (Centene) — independent third-party profile of a public API surface, by API Evangelist. Apixio is a healthcare artificial intelligence company that applies machine learning and natural language processing to unstructured clinical and claims data for value-based care, risk adjustment, HCC coding, payment integrity, and healthcare analytics.

End-to-end healthcare claims analytics using SQL, Python, Power BI, Snowflake-ready modeling, ETL validation, and payment-integrity analysis

Alaffia — independent third-party profile of a public API surface, by API Evangelist. Alaffia (Alaffia Health) is a New York City-based healthtech company building an AI platform that helps health plans reduce improper payments and administrative waste across claims operations.

Machinify — independent third-party profile of a public API surface, by API Evangelist. Machinify is an AI-powered healthcare payment integrity platform that streamlines and automates payment processes for health plans. Its products - Coordinate (claims coordination), Subrogate (subrogation management), Audit (payment audit), Pay (payment processin

Codoxo — independent third-party profile of a public API surface, by API Evangelist. Codoxo is an AI-driven healthcare cost-containment and payment-integrity platform serving health plans, PBMs, and government agencies across more than 80 million lives. Its Forensic AI Platform powers Provider Scope (pre-claim provider education), Audit Scope, Frau