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,

Dispute Review Evaluate provider submitted appeals and original audit findings to validate or revise DRG determinations. Medical Record Analysis Review inpatient medical records, UB 04s, and documentation to ensure correct DRG assignment and adherence to coding, billing, and payment guidelines. DRG Validation Apply clinical validation and coding principles to support or o

Engage in Outbound recovery calls, to Healthcare Carriers and Providers regarding improperly paid claims Decision Support Ability to accurately review supporting documentation provided to Performant, by Providers/Carriers to determine accuracy of finding or overpayment allegation, for Complex appeals and disputes. Maintain current knowledge in Medicare and Medicaid practi

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,

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,

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,

Overview Salary Range $20.00 $20.00 Hourly Level Entry Position Type Part Time Job Shift Day Education Level No Degree Some College Category Accounting Accounting Intern Who We Are 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 co

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,

Leverage knowledge and expertise in COB/TPL/Recovery to gather and review in house data with payer correspondence to determine proper order of benefits and resolve primacy issues. Successfully solve complex data or record discrepancies and/or issues. Communicate effectively with carriers to determine primacy; answer questions and/or provide information that will bring to

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,

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,

Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules. Document all findings referencing the appropriate policies and rules. Generate letters articulating audit findings. Supporting your findings during the appeals process if requested. Working collabor

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,

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,

We are hiring a Senior Technical Data Product Manager to drive the data product roadmap in close partnership with data engineering and architecture leadership. Reporting to the Sr. Director of Product Management for Platform & Data, you will work alongside the VP of Data Engineering, CTO, and technical leads to translate business needs into product requirements and coordi