Claims Administrator I

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 role is full 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. As part of the Complex Payment Solutions Team you will as a Claims Administrator be responsible for supporting efficient claims processing and ensuring data accuracy throughout the review and auditing process. This role involves performing incoming claim reviews organizing data assigning statuses and routing completed files to auditors while maintaining document hygiene and adhering to internal procedures.

The position requires close collaboration with internal teams to manage import queues reconcile balances validate charges identify and address errors and facilitate claims routing. The Claims Administrator I oversee the intake and output of files responding to inquiries resolving discrepancies and ensuring effective communication regarding claims.

Additionally this role includes analyzing data trends monitoring file-sharing processes verifying data transfer accuracy and ensuring appropriate volume levels are maintained. Data entry of documents and other administrative tasks are also integral to the position.

The ideal candidate demonstrates strong organizational skills attention to detail and the ability to work collaboratively in a dynamic environment.

What youll do

• Review incoming claims assign statuses organize data and route files to auditors.
• Collaborate with teams to manage the import queue reconcile balances validate charges correct errors and route files.
• Oversee file intake and output addressing inquiries discrepancies and errors.
• Analyze data trends and communicate updates on claims routing efficiency inventory and volume.
• Monitor file-sharing processes ensure data transfer accuracy and maintain appropriate volume levels.
• Perform data entry and support additional administrative tasks as needed.

• Preferred experience in medical record review and knowledge of medical terminology.
• Proficient in Microsoft Office Suite Adobe Acrobat and multi-monitor setups; adaptable to company-specific software.
• Strong attention to detail organizational analytical and critical thinking skills.
• Excellent interpersonal and teamwork abilities capable of collaborating across functions and driving change.

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: $22.00-$26.00 USD per hour

This is a non-exempt position.

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

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 address . See our Candidate Privacy Notice at: Experience:

Unclear Seniority