Machinify offers AI-powered healthcare payment integrity solutions to enhance claims accuracy, recovery performance, and cost control. Backed by Battery and GV.
About the role
We’re seeking a skilled IBR Policy and Content Development Analyst to join our team! You will be responsible for the development, enhancement, and performance of clinical and coding solutions. This role serves as the primary subject matter expert for payment integrity policies, leveraging expertise in healthcare payment policies, facility billing, coding, and regulatory requirements. Found on 1752vc Careers, the job board for startup and VC roles.
What they're looking for
- 3+ years’ experience performing payment integrity or auditing facility claims
- Experience translating complex medical regulations and payer guidelines into clear, legally compliant clinical content and structured policy documentation
- Deep understanding of Medicare and Commercial coding rules, regulations, and prospective payment systems
- Broad knowledge of medical claims billing/payment systems, provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology
- Knowledge of national coding standards, particularly payment rules
- Strong organizational and written communication skills
More about this role
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.
We’re seeking a skilled IBR Policy and Content Development Analyst to join our team! You will be responsible for the development, enhancement, and performance of clinical and coding solutions. This role serves as the primary subject matter expert for payment integrity policies, leveraging expertise in healthcare payment policies, facility billing, coding, and regulatory requirements. This role works closely with cross-functional teams – including operations, clinical, client services, and IT – to ensure audit concepts are accurately built, validated, and maintained in alignment with...
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