Job Description
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At Machinify, we’re constantly reimagining what’s possible in our industry—creating disruptively simple, powerfully clear ways to maximize our clients’ financial outcomes today and drive down healthcare costs tomorrow.
What you’ll do
- Monitor incoming claim notifications and ensure all required documents are complete and legible.
- Verify all required submission documents are present and legible.
- Perform initial claim setup, accurately enter data, and assign correct claim statuses.
- Perform initial analysis of data and documents submitted by the client such as claims, EOBs, bills, policies, correspondence, etc.
- Combine and extract claim documents when needed.
- Copy combined file and rename according to policy and procedures.
- Enter UB04 data information for analyst.
- Transfer claim documents to Document Management and IBR departments.
- Create appeal letters and return to client.
- Analyze the client-provided coversheet for correct reimbursement.
- Adjust system to reflect the correct reimbursement and savings.
- Escalate claims with problems to Lead of claim processing.
- Notify Lead of Claim Coordinator when documents are missing or illegible.
- Maintain compliance with HIPAA and other security requirements.
- Perform other duties as assigned.
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Machinify
View Company ProfileMachinify is a groundbreaking AI-driven HealthTech and financial technology company that fundamentally reshapes the massive healthcare payment integrity ecosystem. Headquartered in Palo Alto, California, the company operates a powerful "AI operating system" designed to seamlessly untangle complex healthcare data, eliminate systemic friction, and ensure accurate billing. Under the hood, the Machinify platform unifies medical records, claims, policies, and complex contracts into a single data layer, leveraging healthcare-specific foundation models and autonomous AI agents to audit, coordinate, and process payments with industry-leading speed and precision. Recently expanding its massive reach by acquiring Performant Healthcare, the platform serves as an end-to-end payment engine. Their primary target audience spans major health plans—including 18 of the top 20 commercial, Medicare, and Medicaid payers in the US—that need to drastically reduce administrative costs, combat false positives, and recover billions in lost revenue. What sets Machinify apart in the traditionally rigid healthcare infrastructure is its ability to deploy highly flexible, transparent AI that continuously learns via "human-in-the-loop" feedback, driving both massive cost avoidance for insurers and lower overall healthcare costs for the entire ecosystem.
Safety First
- Never pay for a job application.
- Do not share sensitive bank info.
- Verify the client before starting work.