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Machinify
Machinify
7 open remote positions
Machinify is a leading healthcare intelligence company delivering value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans representing more than 270 million lives, the company combines an AI-powered platform with best-in-class expertise in a culture of constant innovation.
Salary Distribution
5 of 7 jobs
PTO Distribution
1 of 7 jobs
Unlimited PTO
1 jobs (14%)
Benefits Overview
4 of 7 jobs
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Open Positions
Optimize massive-scale SQL queries and database performance across multi-terabyte claims datasets to surface overpayments and reduce healthcare costs. Design and maintain advanced indexing, partitioning, and statistics strategies that cut runtime and resource usage at scale. Lead root-cause investigations of data anomalies and performance issues, implementing permanent fixes that compound savings for clients.
SQL Server
T-SQL
Design, build, and operate reliable automated data pipelines for health plan data. Model complex healthcare data into clear, trustworthy canonical and analytical models. Bring legacy processes and pipelines into a common platform, extending tooling for partner teams.
SQL
Python
Dbt
Snowflake
Spark
Manage document workflows, including processing, quality assurance, and adherence to internal procedures. Conduct incoming claim reviews, assign statuses, organize data, and route files to auditors. Collaborate with internal teams to maintain import queues, reconcile balances, validate charges, and correct errors.
Microsoft Office
Adobe Acrobat
Attention To Detail
Analytical
Critical Thinking
Lead a remote team of clinical auditors performing medical record review with primary oversight of Skilled Nursing Facility (SNF) audits. Serve as the primary subject matter authority for SNF audit programs, including Medicare Part A coverage, PDPM, and MDS 3.0. Manage team performance, conduct reviews, and drive continuous improvement in audit accuracy and efficiency.
Leadership
Audit medical claims for government payers, applying medical review guidelines and documenting findings. Generate letters articulating audit findings and support them during the appeals process. Collaborate with the audit team and clients to improve medical policies and minimize appeals.
Utilization Management
ICD-10 Coding
Claims Auditing
Audit skilled nursing facility (SNF) medical claims for medically appropriate services using applicable guidelines and policies. Document findings, generate audit letters, and support audit findings during the appeals process. Work collaboratively with the audit team, clients, and contractors to improve medical policies and audit workflows.
ICD-10
Microsoft Office
Source and author editing content, translating coding rules and reimbursement policy into precise, testable logic. Validate content with claims data, sizing opportunities and measuring accuracy, hit rates, and savings. Partner with Product, Data Science, and clients to turn content concepts into clear requirements and defendable documentation.
Clinical Coding
SQL