Lead Auditor - Healthcare Claims - Remote

Overview

Machinify is seeking a Lead Auditor for post pay data mining to conduct claims audits on behalf of Machinify’s customers, enhancing claims processing efficiency in the healthcare sector.

In Short

• Develop new auditing concepts based on claims payment cycle knowledge.
• Conduct comprehensive reviews of post pay claims.
• Serve as a resource in claims billing and payment.
• Develop reimbursement policies in collaboration with the team.
• Stay updated on healthcare billing guidelines.
• Ensure accuracy and quality in auditing.
• Identify additional recovery opportunities in claims.
• Additional responsibilities as needed.

Requirements

• 10+ years of medical coding and claims auditing experience.
• Experience analyzing payment information against billing guidelines.
• Ability to deliver high-quality work in a fast-paced environment.
• Strong attention to detail and investigative skills.
• Ability to work autonomously and manage priorities.
• Decision-making skills with limited information.
• Proficiency in productivity tools like Excel and Google Sheets.
• Certifications in medical coding and billing.

Benefits

• Work from anywhere in the US.
• Flexible work environment.
• Supportive colleagues and leadership.
• Comprehensive medical, dental, and vision benefits.
• Competitive salary and equity.
• Generous Learning and Development Reimbursement policy.