Payment Integrity Analyst II

Who We Are

Machinify is a leading healthcare intelligence company with expertise across the payment continuum delivering unmatched value transparency and efficiency to health plans. Deployed by over 75 health plans including many of the top 20 and representing more than 170 million lives Machinifys AI operating system combined with proven expertise untangles healthcare data to deliver industry-leading speed quality and accuracy. Were reshaping healthcare payment through seamless intelligence.

Location: This position will be fully remote.

About the Opportunity

At Machinify were constantly reimagining whats possible in our industrycreating disruptively simple powerfully clear ways to maximize our clients financial outcomes today and drive down healthcare costs tomorrow. A COB Analyst II is an integral part of a dynamic team. COB Analyst II utilize claims systems and established resources to determine coordination of benefits and potential claim overpayments for members covered by more than one health coverage. Extensive phone outreach to members employers providers and insurers is often needed to make this determination. The Analyst also handle tasks including but not limited to invoice preparation invoice follow-up and file maintenance.

What youll do

• Reviews and audits healthcare claims to ensure claims payments coordinated properly utilizing Medicare and Commercial primacy rules.
• Effectively communicates with healthcare providers employers members and/or insurance representatives to gather information.
• Resolves issues in a timely fashion.
• Utilizes available resources to maximize identification and recovery of overpayments.
• Creates maintains and closes files in accordance with policies and guidelines.
• Delivers world class customer service and maintain professionalism in all aspects of communication.
• Actively seeks to identify process improvements to increase workflow efficiency.

What experience you bring (Role Requirements)

• Bachelors Degree or equivalent combination of experience in health insurance or related fields which would provide the necessary knowledge skills and abilities to successfully perform the work.
• Very strong attention to detail deductive reasoning and organizational skills.
• Excellent oral and written communication skills including on the phone are required.
• Demonstrate integrity and honesty in all aspects of job performance.
• Ability to work well independently or in a team environment.
• Customer service experience highly preferred.
• Working knowledge of Word and Excel is required.
• Demonstrate integrity and honesty in all aspects of job performance.
• Experience in the healthcare field is helpful but not required.

What Success Looks Like

After 3 months

• You will have a strong understanding of the role.
• You begin building relationships and collaborating with peers.
• You develop effective time and priorities management.
• You receive initial feedback about your performance and are using it to improve.
• Youve gained confidence in your abilities and are starting to feel more comfortable in your role.

After 1 year

• You have mastered the tasks and responsibilities of the position executing them with confidence and efficiency.
• You have established a strong network of internal relationships and are recognized as a key collaborator.
• Youve been entrusted with greater responsibility indicating the companys confidence in your abilities.
• You see opportunities for career progression and personal development.

Pay range: This is an exempt position with an annual base salary of $57500 with bonus opportunity.

Whats in it for you

• PTO Paid Holidays and Volunteer Days
• Eligibility for health vision and dental coverage 401(k) plan participation with company match and flexible spending accounts
• Tuition Reimbursement
• Eligibility for company-paid benefits including life insurance short-term disability and parental leave.
• Remote and hybrid work options

What values well share with you

• Ask why
• Think big
• Be humble
• Optimize for customer impact
• Deliver results

At Machinify were reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity teamwork accuracy and flexibility. We do the right thing and we listen to the needs of our clients and their members. As tenured experts with unmatched experience we champion diverse perspectives that help us to better understand and serve our clients.

Our values come to life through our culture. We embrace flexible working arrangements that allow our employees to bring innovation to life in the way that best suits their productivity. We work cross-functionally abandoning silos to bring innovative and accurate solutions to market. We invest in each other through ongoing education and team celebrations and we give back to our communities through dedicating days for volunteering. Together Machinify is making healthcare work better for everyone and were passionate about a future with better outcomes for all.

We are committed to equal employment opportunity regardless of race color ancestry religion sex national origin sexual orientation age citizenship marital status disability gender gender identity or expression or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable accordance with applicable state laws we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process please contact our People Operations team at . See our Candidate Privacy Notice at: