Backed by Battery and GV.
About the role
Master Claim Audits: Dive into various clinical and coding audits, unpacking the data that drives audit decisions, and understanding past outcomes. Model Advancement: Curate labeled data, hypothesize new features, and develop ML models that target claims for audit with even greater precision.
What they're looking for
- Work from anywhere in the US! Machinify is digital-first
- Top Medical/Dental/Vision offerings
- Tuition reimbursement
- Competitive salary, 401(k) with company match
- Unlimited PTO
- Additional health and wellness benefits and perks
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.
Our team builds machine learning models for some of the largest health plans in the country to identify and audit claims errors from simple errors to outright fraud. Large insurance payers receive tens of millions of claims each year, of which they only are able to audit less than 10%. Our claim selection models help with selecting the right set of claims to audit and recover hundreds of millions of dollars each year reducing wasted medical spend. We have made significant progress already, with models that significantly outperform even selection by human experts but there are still...
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