AI Solutions for Healthcare

Our Team

Leadership Team

Musheer Ahmed, PhD

CEO and Founder

Dr. Ahmed is the CEO and Founder of Codoxo. He founded Codoxo (formerly named FraudScope) to help make our healthcare system more affordable and effective. Codoxo’s Forensic AI Platform uses patented technology to identify problems and suspicious behavior earlier than traditional techniques, which helps ensure our scarce healthcare dollars go to real patient care. Dr. Ahmed developed this technology as a part of his Ph.D. dissertation at the Georgia Institute of Technology. A report by the JASON advisory group, the prestigious scientific advisory panel to the US government, reinforced that his doctoral research tackled some of the biggest challenges within the emerging health data infrastructure in the United States. Several media outlets have interviewed Dr. Ahmed for his work in reducing healthcare fraud, waste, and abuse. When he’s not fighting healthcare fraud, you’ll find him volunteering for various causes and spending time with his family.

Mustaque Ahamad, PhD

Chief Scientist and Co-Founder

Dr. Ahamad is the Chief Scientist and Co-Founder of Codoxo. He is also Co-Founder and Chief Scientist at Pindrop Security and a professor of computer science at the Georgia Institute of Technology. Pindrop Security is a leader in phone fraud prevention with a total financing of $122 million from top-tier investors, such as Andreessen Horowitz, Citi Ventures, Felicis Ventures, Redpoint Ventures, and Webb Investment Network. Dr. Ahamad has held multiple leadership roles within academia over the years and is currently the Associate Director of Education and Outreach at the Georgia Tech Institute for Information Security & Privacy.

Rena Bielinski, PharmD, AHFI 

VP of Customer Success

Dr. Bielinski is the Vice President of Customer Success at Codoxo. She has a Doctor of Pharmacy degree from the University of Illinois College of Pharmacy in Chicago (UIC), and she is also an Accredited Healthcare Fraud Investigator (AHFI). Prior to Codoxo, she spent 15 years at SCIO Health Analytics, an EXL Company, where she was the Chief Pharmacy Officer, with responsibility for building several clinical cost containment programs. She also developed the Retail Pharmacy FWA program which included pharmacy fraud investigations and compliance audits. She also served as a Vice President of Strategic Accounts at EXL, managing multiple payer and PBM clients. Dr. Bielinski was also an Industry Thought leader, with multiple publications and speaking engagements. Prior to SCIO, she spent many years as the Chief Operating Officer for a regional home infusion, home health, and DME company.

Prasoon Saurabh

VP of Engineering

Prasoon Saurabh serves as VP of Engineering at Codoxo. He is a transformational product engineering and product management leader with a 20+ year track record of delivering innovative technology at startup, mid-size and large companies. Prasoon has created and scaled businesses and products in Healthcare AI, Cloud/SaaS, Enterprise Software, Mobile Platforms, Networking, Telecommunication, Security, Robotics and Service Provider segments. He was most recently the Vice President of Engineering at Ventureforth, a cloud mobile company where he built multiple disconnected mobile SaaS products connecting to multiple ERPs. Prasoon has also held leadership roles at Earthlink and 3COM. He brings significant experience in product strategy, innovating new technologies and execution to Codoxo. Prasoon has a Bachelor’s of Engineering in Computer Sciences from Amravati University and holds multiple patents.

Rajesh Razdan

VP of Products

Rajesh Razdan is the Vice President of Products at Codoxo. He brings over 20 years of product leadership experience working for some of the most innovative venture-backed SaaS companies in Silicon Valley. Prior to Codoxo, he served as the Vice President of Products at Castlight Health. At Castlight, Rajesh built the Health Plan Solutions division from ground-up and served some of the largest health plans in the US. Earlier in his career, Rajesh held product leadership roles at category leading technology companies including Okta and TIBCO.  Rajesh holds a bachelor’s in Computer Science and Engineering from University of Mysore, India.  

Jesse Montgomery

VP of Market Strategy

As Vice President of Market Strategy, Jess is responsible for spearheading strategic leadership efforts, driving the development and execution of comprehensive strategies to enhance market expansion and foster robust partnership. He brings over 20 years of experience as an adaptive leader across many aspects of healthcare including payment integrity, analytics, business intelligence, product development, Information Technology, product management, reimbursement and medical policy, shared savings, and other areas of healthcare.  

 Prior to joining Codoxo, Jess held positions leading strategy for health plans and healthcare organizations. There he focused on transformation, advancing capabilities for payment integrity, data science, analytics, clinical review, policy development, payment and network strategies, and areas of innovation. 

Toby Shum

VP of Finance

Toby is Codoxo’s Vice President of Finance. He brings over 25 years of financial management and corporate development experience across healthcare, fintech, consumer lending and banking. Toby was Senior Vice President of Finance at Aledade, a leader in value-based care and the largest independent primary care network. Prior to Aledade, Toby was with Fenway Summer, a Fintech-focused venture investment and advisory firm. Toby began his career at Capital One in the credit card division and went on to work in the mergers and acquisitions team.

Toby serves on the Board of Willow Oak Therapy Center, a non-profit counseling service in Rockville, Maryland. He holds a First-Class Joint Honors degree in Economics and Finance from McGill University.

Stacia Whelan

Marketing Director

As Marketing Director, Stacia is responsible for leading marketing strategy and supporting organizational growth for Codoxo. She has over fifteen years of experience in healthcare across many facets including hospital/health systems, ACOs and payer organizations, and brings significant expertise in marketing strategy, digital marketing, brand and thought leadership.

Prior to joining Codoxo, she held various positions managing marketing strategy across such areas as clinical services, population health, risk adjustment, and healthcare analytics. Stacia received her Bachelor of Business degree from Western Michigan University.

Careers at Codoxo

1 billion

CLAIMS
PROCESSED

$500M

Identified
savings

%

Reduction in false positives

%

Increase in productivity

We invest heavily in our people and our technology to help us push the boundaries of what’s possible.
We have helped achieve savings at world-class payers and healthcare agencies including:

Highmark

6+ million members

State Medicaid Agency

1.5+ million recipients

Southeast Health Plan

3.5+ million members

Pacific Health Plan

700k+ members

Mid-State Health Plan

3.5+ million members

Midwest Plan

2.5+ million members

We invest heavily in our people and our technology to help us push the boundaries of what’s possible.

We have helped achieve savings at world-class payers and healthcare agencies including:

Highmark

6+ million members

State Medicaid Agency

1.5+ million recipients

Southeast Health Plan

3.5+ million members

Pacific Health Plan

700k+ members

Mid-State Health Plan

3.5+ million members

Midwest Plan

2.5+ million members

– Kurt Spear, Vice President Financial Investigations and Provider Review
HIGHMARK

– Kurt Spear, Vice President Financial Investigations and Provider Review
HIGHMARK

FORENSIC AI PLATFORM

Our Forensic AI Engine analyzes your data, detects problems, and builds connections across your data to provide actionable insights

Insight Scope

For everyone across the health plan

Clinical Scope

For clinical teams

Audit Scope

For everyone across the health plan and PBM

Network Scope

For network teams

Payment Scope

For payment integrity teams

Provider Scope

For network and payment teams

Fraud Scope

For SIU teams

SERVICES

We provide a full range of professional services, from data migration and ongoing customer success through flexible virtual SIU options.