Machinify

Healthcare Customer Service Specialist II (SCA)

Machinify · Full Time · 15 hours ago

Machinify

🌎 United States ⭐ 2-5 yrs exp 💼 Support

Serve as the primary point of contact for providers and Medicare contractors to resolve complex inquiries via phone, email, and written correspondence. Maintain accurate tracking logs and perform due diligence to ensure compliance with CMS contract requirements.

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Complex Clinical Claims Analyst

Machinify · Full Time · 4 days ago

Machinify

🌎 United States 💵 $100K - $110K per year ⭐ 2-5 yrs exp 💼 Finance

Perform detailed clinical and coding reviews of facility claims to ensure billing accuracy and appropriateness of care. Develop complex claims review content and act as a subject matter expert for client initiatives and internal training.

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Subrogation Analyst

Machinify · Full Time · 5 days ago

Machinify

🌎 United States ⭐ 2-5 yrs exp 💼 Others

Investigates health insurance claims to identify recoverable funds from liable third parties. Negotiates with insurance adjusters, attorneys, and members while documenting findings and processing recovery payments.

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DRG QA and Trainer

Machinify · Full Time · 6 days ago

Machinify

🌎 United States 💵 $85000 - $95000 per year ⭐ 2-5 yrs exp 💼 Teaching

Oversee quality assurance for DRG Reviewers to ensure adherence to clinical and coding standards. Conduct training sessions for new and existing staff to enhance skills and maintain compliance.

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Claims Administrator

Machinify · Full Time · 7 days ago

Machinify

🌎 United States ⭐ 0-2 yrs exp 💼 Software Development

The Claims Administrator supports efficient claims processing by reviewing incoming claims, organizing data, and routing files to auditors. They are also responsible for managing import queues, reconciling balances, and monitoring data transfer accuracy.

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Manager, Medical Review Coding — Behavioral Health

Machinify · Full Time · 8 days ago

Machinify

🌎 United States 💵 $130K - $140K per year ⭐ 5-10 yrs exp 💼 Healthcare

Oversee the operational results and quality of a remote behavioral health coding audit team. Drive strategy for capacity planning, staffing models, and the development of review guidelines aligned with regulatory requirements.

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Team Attorney, Subrogation

Machinify · Full Time · 13 days ago

Machinify

🌎 United States 💵 $80000 - $120K per year ⭐ 0-2 yrs exp 💼 Legal

Provide legal support and guidance to subrogation recovery teams and the General Counsel. Ensure adverse suits are handled appropriately and train analysts on relevant legal statutes and regulations.

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Staff Data Engineer, Core Migrations

Machinify · Full Time · 13 days ago

Machinify

🌎 United States 💵 $180K - $220K per year ⭐ 10+ yrs exp 💼 Software Development

Lead the end-to-end technical and operational ownership of client migrations, from legacy system analysis to production deployment. Architect and build scalable migration pipelines using Airflow and Spark while ensuring 100% data fidelity.

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Technical Engineering Manager | COB Product

Machinify · Full Time · 15 days ago

Machinify

🌎 United States 💵 $230K - $260K per year ⭐ 10+ yrs exp 💼 Others

Lead the engineering team in building a scalable, AI-driven cloud-native solution for Coordination of Benefits (COB). Own the technical roadmap, architecture, and production releases while managing and coaching a team of 5-6 engineers.

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SQL Prompt Engineer Analyst

Machinify · Full Time · 17 days ago

Machinify

🌎 United States 💵 $140K - $170K per year ⭐ 2-5 yrs exp 💼 Software Development

Develop advanced SQL and Spark SQL expressions to transform complex healthcare claims data into actionable business insights. Utilize prompt engineering with LLMs like Claude and OpenAI to automate medical record research and clinical case reviews.

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Medical Review Nurse - CMS/RAC Auditor, Government Audits

Machinify · Full Time · 18 days ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Finance

Perform medical claims audit reviews for government clients to ensure services provided are medically appropriate. Document findings, generate audit letters, and collaborate with teams to improve medical policies and workflows.

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Information Security Analyst

Machinify · Full Time · 19 days ago

Machinify

🌎 United States 💵 $70000 - $95000 per year ⭐ 0-2 yrs exp 💼 Software Development

Manage security assurance operations by triaging customer requests, responding to security questionnaires, and maintaining documentation. Support audit preparation for HITRUST and SOC 2 while assisting with general security program metrics and vendor risk assessments.

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Senior Events Manager (Contract)

Machinify · Full Time · a month ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Manage end-to-end event operations including industry conferences, webinars, and the annual customer summit. Coordinate logistics, budget tracking, and lead capture while reporting performance metrics to executive leadership.

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Medical Review Nurse - SNF/MDS Auditor

Machinify · Full Time · a month ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Finance

Perform retrospective and prepayment medical claims audits for Skilled Nursing Facility (SNF) services. Document findings, generate audit letters, and collaborate with clients to improve medical policies and provider education.

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Medical Review Nurse - Clinical Validation

Machinify · Full Time · a month ago

Machinify

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Perform retrospective and prepayment medical claims audits for inpatient settings using established guidelines and policies. Document findings, generate audit letters, and collaborate with the team to identify potential abuse and improve workflows.

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Sr. Product Manager | Pharmacy Payment Integrity

Machinify · Full Time · a month ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Product

Lead the transformation of pharmacy payment integrity from manual workflows to AI-first automation, owning the roadmap for AI agents and voice AI. Design automated payment recovery workflows and redesign customer-facing analytics portals to demonstrate ROI.

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Quality Validation Specialist

Machinify · Full Time · 2 months ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Perform secondary reviews of outpatient coding validation audits to ensure accuracy, consistency, and compliance with regulatory standards. Monitor auditor performance, provide coaching, and develop quality assurance tools to improve operational excellence.

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Sr. Director | Engineering, ML

Machinify · Full Time · 2 months ago

Machinify

🌎 United States ⭐ 10+ yrs exp 💼 Software Development

Lead and grow the AI/ML Engineering team to design, deliver, and operate a scalable core AI/ML platform. Partner with the Chief AI Officer to bridge the gap between data science proof-of-concepts and production-grade services.

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Client Success Leader

Machinify · Full Time · 2 months ago

Machinify

🌎 United States 💵 $130K - $160K per year ⭐ 5-10 yrs exp 💼 Sales

Lead client interactions and operational processes to improve satisfaction and value within a healthcare payment integrity platform. Collaborate with technical teams to deliver actionable insights from claims data and manage client strategy and reporting.

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DMG Data Mining Analyst II

Machinify · Full Time · 2 months ago

Machinify

🌎 United States 💵 $90000 - $140K per year ⭐ 5-10 yrs exp 💼 Software Development

Extract hidden patterns and insights from large healthcare datasets to drive business strategy and operational efficiency. Lead small data projects and create comprehensive reports and visualizations to communicate results to diverse audiences.

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Sr/Staff Software Engineer, Fullstack| Product

Machinify · Full Time · 2 months ago

Machinify

🌎 United States 💵 $215K - $255K per year ⭐ 10+ yrs exp 💼 Software Development

Design and build scalable, reliable full-stack web applications that apply ML techniques to large volumes of data. Balance the development of new customer-facing features with technical debt cleanup to ensure software sustainability.

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Technical Program Manager

Machinify · Full Time · 2 months ago

Machinify

🌎 United States 💵 $180K - $240K per year ⭐ 5-10 yrs exp 💼 Product

Manage software development project delivery schedules and coordinate cross-functional efforts between Data Science, Engineering, and DevOps. Drive engineering processes and ensure product requirements align with end-to-end delivery commitments.

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Staff Data Scientist | ML

Machinify · Full Time · 2 months ago

Machinify

🌎 United States ⭐ 10+ yrs exp 💼 Software Development

Own end-to-end data science workflows to build and productionize ML and LLM-powered solutions for healthcare payment intelligence. Lead high-impact initiatives and set technical direction through mentorship and design reviews to improve business outcomes.

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Product Marketing Manager

Machinify · Full Time · 2 months ago

Machinify

🌎 United States ⭐ 2-5 yrs exp 💼 Product

Develop and refine product messaging, positioning, and value propositions to translate complex AI capabilities into clear narratives for healthcare payers. Support the creation of sales enablement tools, video content, and the coordination of product launches.

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Senior Product Manager

Machinify · Full Time · 3 months ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Product

You will own the end-to-end product lifecycle for the Coordination of Benefits (COB) line, including strategy, roadmap, and execution. You will drive the vision for AI-native workflows to improve claims recovery and operational efficiency.

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APC Coding Validation Specialist

Machinify · Full Time · 3 months ago

Machinify

🌎 United States 💵 $85000 - $100K per year ⭐ 5-10 yrs exp 💼 Others

Conduct comprehensive outpatient payment validation reviews to ensure accurate coding, billing, and compliance with payer policies. Document audit findings and provide well-supported rationales for reimbursement impacts using industry-standard references.

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Nurse Itemized Bill Reviewer (IBR Analyst)

Machinify · Full Time · 3 months ago

Machinify

🌎 United States 💵 $80000 - $90000 per year ⭐ 2-5 yrs exp 💼 Healthcare

The analyst will review facility insurance claims and itemized statements to ensure the accuracy of charges against medical documentation and compliance guidelines. They will also collaborate with internal teams to improve claim review efficiency and assist in content development and research.

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Software Architect

Machinify · Full Time · 3 months ago

Machinify

🌎 United States 💵 $230K - $280K per year ⭐ 10+ yrs exp 💼 Software Development

The Software Architect will own the design and implementation of the intelligent document processing and agentic evaluation framework. This role involves hands-on technical leadership, defining system abstractions, and ensuring the platform scales to process healthcare documents at a high volume.

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Senior Director, Government Business Development

Machinify · Full Time · 3 months ago

Machinify

🌎 United States 💵 $195K - $220K per year ⭐ 10+ yrs exp 💼 Sales

The Senior Director will lead end-to-end business development across federal and state government markets, focusing on Medicaid and federal health agencies. They will manage the full sales cycle, including RFP responses, strategic partnerships, and policy-driven market positioning.

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Technical Data Product Manager

Machinify · Full Time · 3 months ago

Machinify

🌎 United States 💵 $180K - $260K per year ⭐ 10+ yrs exp 💼 Product

You will drive the data product roadmap by partnering with engineering and architecture leadership to translate business needs into technical requirements. The role involves coordinating the consolidation of legacy systems into a unified AI-powered platform while enabling new product capabilities across the healthcare payment continuum.

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Data Scientist | Modeling

Machinify · Full Time · 3 months ago

Machinify

🌎 United States 💵 $180K - $230K per year ⭐ 5-10 yrs exp 💼 Software Development

Develop and advance machine learning models to optimize healthcare claim audits and improve financial outcomes. Create technical frameworks and data pipelines to enhance team efficiency and model precision.

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Senior Data Engineer 

Machinify · Full Time · 3 months ago

Machinify

🌎 United States 💵 $180K - $220K per year ⭐ 5-10 yrs exp 💼 Software Development

Design and implement robust, production-grade data pipelines to process high-volume datasets and integrate raw customer data into internal models. Collaborate with cross-functional teams to ensure data accuracy, observability, and performance while supporting ML models and product experiences.

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Medical Coder [remote]

Machinify · Full Time · 4 months ago

Machinify

🌎 United States 💵 $90000 - $115K per year ⭐ 2-5 yrs exp 💼 Software Development

The role involves conducting thorough DRG payment validation reviews, including clinical and coding assessments of medical records to ensure accurate payment determinations based on contract-specific criteria. Key duties include meticulously documenting findings, providing clinical and policy support, and collaborating with stakeholders to maintain compliance with payment standards.

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Senior Software Engineer (Data Platform)

Machinify · Full Time · 4 months ago

Machinify

🌎 United States 💵 $180K - $220K per year ⭐ 5-10 yrs exp 💼 Software Development

The role involves designing and building scalable, high-performance data software solutions primarily using Golang and Python, while also building and deploying Kubernetes-based systems for containerized applications in cloud-native environments. Engineers will collaborate cross-functionally to optimize backend infrastructure performance, reliability, and security, focusing on data transformation for machine learning workflows.

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DRG Manager

Machinify · Full Time · 4 months ago

Machinify

🌎 United States 💵 $125K - $140K per year ⭐ 5-10 yrs exp 💼 Others

The DRG Manager will be responsible for the development and management of clinical solutions, including MS and APR-DRG validation, requiring expertise in healthcare payment methodologies and audit criteria. Key duties involve leading the DRG team, overseeing clinical claims review processes, monitoring regulatory updates, and ensuring optimal team performance.

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Data Scientist | Clinical AI

Machinify · · 5 months ago

Machinify

🌎 United States ⭐ 2-5 yrs exp 💼 Software Development

The Data Scientist will translate complex medical policies and clinical criteria into executable SQL and Python code, focusing on building robust clinical feature pipelines from extracted signals in medical records. They will also own the measurement, evaluation, and continuous quality improvement of the AI system responsible for extracting structured clinical information.

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Staff Data Scientist | Fraud / Billing

Machinify · · 5 months ago

Machinify

🌎 United States ⭐ 10+ yrs exp 💼 Software Development

This role is responsible for leading the build and deployment of classical Machine Learning and Generative AI systems to generate and validate concepts related to billing errors, audits, and fraud within large-scale healthcare payment data. The Staff Data Scientist will own the end-to-end delivery process, from problem framing and data strategy through model development, evaluation, deployment, and monitoring, focusing on reliability and customer outcomes.

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NLP Scientist

Machinify · · 5 months ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

The role involves solving complex problems in medical document understanding and question-answering by applying modern Natural Language Processing and vision methodologies. Responsibilities include making data-driven decisions on algorithms, working with limited labeled data, and continuously optimizing models for production scalability and performance.

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Staff Software Engineer | GenAI & Agentic Workflows

Machinify · · 5 months ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

The Staff Software Engineer will lead the design and development of large-scale systems to integrate cutting-edge AI into production for Payment Integrity and Audit solutions. This includes leading document processing pipelines and designing agentic workflows to review and validate millions of healthcare claims annually.

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Staff Data Scientist | Modeling

Machinify · · 5 months ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

The Staff Data Scientist will be responsible for advancing machine learning models used for identifying and auditing claims errors, requiring deep dives into clinical and coding data to improve audit precision. This role also involves enhancing data pipelines, modeling infrastructure, and team tools to scale capabilities and ensure model insights align with real business needs.

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Staff Frontend Engineer | Web Apps & Platform

Machinify · Full Time · 5 months ago

Machinify

🌎 United States 💵 $200K - $240K per year ⭐ 10+ yrs exp 💼 Software Development

Develop new applications and contribute to UI and middle-layer development. Collaborate with team and external stakeholders to design and implement solutions for an intuitive user experience.

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Lead Software Engineer, Backend | Product

Machinify · Full Time · 5 months ago

Machinify

🌎 United States 💵 $200K - $245K per year ⭐ 10+ yrs exp 💼 Software Development

The engineer will act as a Rust Coach/Multiplier, setting standards, mentoring others, and building production-grade systems in Rust while contributing to new product development of complex in-browser applications. Responsibilities also include architecting and implementing complex applications that apply Machine Learning techniques to large data volumes and balancing feature development with technical debt cleanup.

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Staff Software Engineer, Backend | Web Apps

Machinify · Full Time · 5 months ago

Machinify

🌎 United States 💵 $200K - $245K per year ⭐ 10+ yrs exp 💼 Software Development

Contribute to backend server-side development to ensure the application is extensible, scalable, and secure. Deliver resilient enterprise software solutions while recognizing and prioritizing customer deliverables and tech debt.

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Senior Content Analyst (Claims editing)

Machinify · Full Time · 5 months ago

Machinify

🌎 United States ⭐ 5-10 yrs exp 💼 Legal

The Senior Content Analyst will interpret healthcare reimbursement policies and translate them into automated claims editing logic. This role involves owning edit concepts from interpretation through validation and ongoing refinement.

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DRG Reviewer

Machinify · Full Time · 5 months ago

Machinify

🌎 United States 💵 $90000 - $105K per year ⭐ 2-5 yrs exp 💼 Others

The DRG Reviewer will conduct thorough DRG payment validation reviews, including clinical and coding assessments of medical records according to contract-specific criteria. This involves meticulously documenting findings, providing clinical and policy support, and collaborating with stakeholders to ensure compliance with payment standards.

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