# Payment Integrity Concept Development Analyst - Outpatient at Machinify

- Company: Machinify
- What the company does: Backed by Battery and GV.
- Company website: http://www.machinify.com/
- Type: Startups
- Level: Analyst
- Location: US
- Work setup: On-site
- Pay: $80K to $120K base salary per year (USD)
- Posted: 2026-07-27
- Apply by: 2026-10-08
- Apply: https://job-boards.greenhouse.io/machinifyinc/jobs/4330507009
- Page: https://www.1752.vc/careers/jobs/machinify-payment-integrity-concept-development-analyst-outpatient/

## About the role

As part of the Complex Payment Solutions Team, the Concept Development Analyst applies subject matter expertise across government and commercial healthcare claim types to lead the development, maintenance, testing, and optimization of payment integrity audit concepts.

## What they're looking for

- Bachelor's degree in health administration, business, nursing, or a related field, or equivalent experience
- Minimum 5+ years of progressive experience in healthcare claim type subject matter specialty, including direct experience in payment integrity and claims auditing
- Equivalent experience of 3+ years in claims auditing and recovery auditing
- Registered Nurse or Certified Coder holding a nationally recognized credential (RHIA, RHIT, AHIMA, AAPC, or equivalent) required
- Demonstrated depth and breadth of knowledge across payment integrity elements, including: ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and HIPPS coding systems and MS-DRG, APR-DRG, APC, APG, PDPM, and PDGM payment methodologies
- Deep understanding of Medicare and Commercial coding rules, regulations, and prospective payment systems

Tags: Clinical & Coding Auditors