Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating activities:
Net income	$ 12,682	$ 19,642
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization of property, equipment and software	8,024	7,930
Amortization of intangible assets	3,679	2,339
Amortization of deferred financing costs	141	141
Stock-based compensation expense	13,510	10,979
Deferred income taxes	940	1,225
Noncash lease expense	949	1,196
Changes in operating assets and liabilities:
Accounts receivable	(9,910)	1,977
Prepaid expenses and other current assets	8,694	(2,136)
Other assets	(4,469)	(766)
Income taxes receivable	2,686	1,189
Accounts payable, accrued expenses and other liabilities	(19,126)	(15,995)
Operating lease liabilities	(1,042)	(1,519)
Liability for appeals	336	2,320
Net cash provided by operating activities	17,094	28,522
Investing activities:
Purchases of property and equipment	(1,678)	(369)
Investment in capitalized software	(3,339)	(3,621)
Net cash used in investing activities	(5,017)	(3,990)
Financing activities:
Proceeds from exercise of stock options	125	23,139
Payments of tax withholdings on behalf of employees for net-share settlements	(3,335)	(6,768)
Payments on capital lease obligations	(102)	8
Net cash (used in)/provided by financing activities	(3,312)	16,379
Net increase in cash and cash equivalents	8,765	40,911
Cash and Cash Equivalents
Cash and cash equivalents at beginning of year	139,268	178,946
Cash and cash equivalents at end of period	148,033	219,857
Supplemental disclosure of cash flow information:
Cash paid for income taxes/(refunds received), net of refunds	585	(4,288)
Cash paid for interest	2,134	2,771
Supplemental disclosure of non-cash activities:
Change in balance of accrued property and equipment purchases	$ (2,824)	$ (201)