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Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
The HCS Operations Support Services team performs activities to healthcare audit client inventory activities such as claim re-pricing, client inventory status reporting, responding to client inquiries, researches and resolves issues that may arise, and other client account ad-hoc reporting and inventory support activities. This position supports short and long term operational/strategic business initiatives, working closely with the business units and the audit teams as well as other team members to ensure on-time deliverables.
Key Responsibilities
Monitors internal and external reports and take specific actions based on the information
Responds to client correspondence and email request for information
Maintains provider information
Re-prices claims using client contracts and systems
Creates, documents, and modifies processes for new and existing clients as needed
Participates in special ad hoc projects and program initiatives as assigned
Contributes to team effort by completing assigned projects on time
Receives feedback and adjusts work priority as necessary
Performs other duties as assigned
Knowledge, Skills and Abilities Needed
Outstanding written and verbal communication skills
Good critical thinking, questioning, and listening skills; excellent attention to detail
Problem-solving and task management skills
Time management skills for managing multiple tasks simultaneously, while completing work within allocated time frames
Ability to handle changing situations and work within a diverse group
Strong Microsoft Office suite knowledge
Ability to work independently but also as a member of a team
Ability to meet objectives with minimal supervision
Strong technical skills are desired
Ability to work effectively with diverse teams is desired
Can meet objectives with minimal supervision
Required and Preferred Qualifications
High School Diploma/GED is required
Some college, Associate's or Bachelor’s degree preferred
Health care data analysis experience including gathering and documenting requirements for projects of all sizes a plus.
Experience using Microsoft Excel and other Microsoft Office applications.
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