Machinify

Implementation Specialist

• Lead end‑to‑end implementation cycles, including discovery, data readiness, configuration, integration, UAT, go‑live, and post‑launch transition.
• Develop and maintain project plans, timelines, milestones, RAID logs, risk mitigation plans, and status reports.
• Facilitate internal and external project meetings, including kickoffs, milestone reviews, and working sessions.
• Oversee cross‑functional project teams to ensure timely completion of tasks and proactive issue resolution.
• Identify and mitigate risks; escalate blockers to leadership as needed.
• Ensure implementation activities meet quality standards, data security requirements, contractual obligations, and industry regulations (e.g., HIPAA, CMS).
• Serve as the primary point of contact during implementation, ensuring a responsive, solution-oriented client experience.
• Provide clear and timely updates, action items, and next steps.
• Prepare and deliver client-facing materials including status decks, project updates, training materials, and process documentation.
• Present complex or technical concepts to both technical and non-technical stakeholders, including client leadership.
• Coordinate data mapping, validation, ingestion, and quality checks across healthcare file types (claims, eligibility, provider, pharmacy, etc.).
• Transcribes requirements into actionable tickets, supporting grooming and sprint planning with Engineers.
• Demonstrate strong understanding of analytics workflows, data mining concepts, audit/recovery processes, and payment integrity operations.
• Support integrations related to complex claims audits, COB, subrogation, pharmacy, data mining services, payment integrity algorithms, and other related workflows.
• Design, refine, and optimize operational workflows based on client requirements and product capabilities.
• Diagnose operational or system-related issues and collaborate internally to resolve them.
• Develop user guides, SOPs, quick-start guides, implementation plans, and process maps for client and internal use.
• Maintain clear, auditable documentation for all implementation activities.
• Deliver training on platform features, workflows, AI-driven tools, and processes to clients and internal teams.
• Partner with Product, Data Engineering, Analytics, Client Success, Compliance, and Operations to ensure implementation readiness and alignment.
• Provide feedback to improve implementation methodologies, tools, templates, and overall process efficiency.
• Support onboarding, coaching, and knowledge transfer for new Implementation team members.
• Contribute to continuous improvement initiatives that enhance scalability, quality, and efficiency.

Implementation Manager

Analyst

• Investigate and determine whether medical insurance claims are recoverable or non-recoverable from a liable third party.
• Communicate and negotiate with healthcare plan members, insurance adjusters, and attorneys.
• Utilize computer systems to accurately document collected information.
• Apply organizational, analytical, and time management skills to manage daily workflow.
• Review and understand healthcare contracts.
• Create medical expense spreadsheets and processes payments from recoveries.

Subrogation Analyst – Recovery Coordination

• Lead pre and post-pay claim reviews to identify inaccurate payments using reimbursement and contract expertise.
• Analyze and interpret provider contracts to ensure payments align with negotiated terms, methodologies, and payer rules.
• Collaborate closely with engineering and data science teams to translate business and reimbursement logic into analytical and automation frameworks.
• Research and document emerging reimbursement and contract patterns, coverage rules, and billing practices to inform concept development.
• Translate complex reimbursement and contract scenarios into structured rules and business logic for implementation.
• Analyze claim-level data to pinpoint root causes of overpayments or incorrect denials and recommend corrective approaches.
• Maintain expertise on CMS and commercial payer reimbursement guidelines.
• Support quality review, concept validation, and process improvement initiatives.

Senior Analyst, Data Mining

Data Scientist

• Dive into various clinical and coding audits, unpacking the data that drives audit decisions, and understanding past outcomes.
• Curate labeled data, hypothesize new features, and develop ML models that target claims for audit with even greater precision.
• Measure model performance rigorously, translating outcomes into operational insights and recommendations for our clients.
• Work with vast, nuanced data pipelines derived from intricate business workflows—often unclean and undefined—to refine them for robust modeling.
• Enhance data pipelines, modeling infrastructure, and team tools to level up our capabilities and decision-making efficiency.
• Build expertise in healthcare data and make an impact on the industry. Engage with clients and internal experts to refine model insights, ensuring alignment with real business needs.

Data Scientist – Modeling

Frontend Engineer

• Develop new applications & contribute towards the UI and potentially middle-layer development
• Own projects aligned with our product development strategy
• Design and implement solutions to achieve a delightful and intuitive user experience
• Contribute to the underlying platform to ensure it is extensible, scalable, and secure
• Collaborate with team and external stakeholders such as Product Managers, Backend Engineers, UX team, & our customers

Staff Software Engineer – Frontend

Product Marketing

• Assist in developing and refining product messaging, positioning, and value propositions across the platform –so buyers and the people who influence them understand “why Machinify” and “why now.”
• Translate complex AI-powered capabilities into clear, defensible value propositions for payer audiences (executive, clinical, operations, and payment integrity).
• Partner with product, sales, and operations teams to incorporate feedback into messaging and content.
• Support the development of personas by gathering and synthesizing customer, sales, and market insights.
• Help map customer pain points and workflows across the payment integrity lifecycle.
• Support video content development, including scripting, coordinating with subject matter experts, and working with creative teams. Potential output includes product explainers, “what it is/why it matters” modules, release highlights, and buyer-specific narratives that reduce time-to-understanding.
• Contribute to the creation of core marketing assets such as product collateral, sales enablement materials, and short-form content.
• Help develop launch materials, internal communications, and enablement resources.
• Assist in coordinating product launches in partnership with Product Operations and Marketing.
• Help create and maintain sales tools such as pitch decks, one-pagers, and competitive insights.
• Work with sales teams to understand common objections and areas where messaging can improve.
• Contribute to training and enablement efforts to support field teams.

Product Marketing Manager

• Independently partner with business stakeholders to understand complex operational challenges, build domain context, and frame analytical approaches — without predefined solutions or heavy direction
• Perform deep exploratory data analysis across payment operations, chart review workflows, and customer performance metrics to diagnose root causes and identify optimization opportunities
• Build and maintain dashboards and reporting infrastructure that give leaders real-time visibility into operational and financial performance
• Conduct business reviews including month-to-month bridges, waterfall analyses, and price-volume-mix decompositions to explain performance variance
• Use LLMs and AI-assisted tools (e.g., Claude, GPT) for data exploration, pattern identification, and accelerating analytical workflows
• Translate ambiguous business questions into structured analytical approaches with clear, actionable recommendations
• Work with both models and querying to understand problems — diagnosing first, then standardizing and building scalable solutions
• Partner cross-functionally with Product, Data Science, Engineering, and Operations teams to deliver analytics-ready solutions
• Build foundational data assets — base data sets, aggregates, and pipelines — required for robust reporting and insight generation

Staff Data Scientist, Analytics

Medical Billing and Coding

• Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement.
• Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers.
• Collaborate with team leaders to ensure thorough review of DRG denials.
• Conduct audits in alignment with organizational quality and timeliness standards.
• Use proprietary auditing systems proficiently to make consistent determinations and generate audit letters.
• Recommend improvements to the audit system to enhance efficiency.
• Ensure compliance with HIPAA regulations for protected health information.
• Perform other duties as assigned.

Medical Coder

• Perform an in-depth review of medical claims utilizing the UB-04 and detailed itemized statement to ensure the validity of line-item charges.
• Verify accuracy of the itemized charges to be reimbursed according to client policy and industry standards.
• Validate automatic system denials and create additions to enhance efficient processing of IBR claims.
• Recommend system enhancements and edits to improve claim review efficiency.
• Comply with company standards regarding accuracy and productivity to manage daily assignments and meet client turnaround times.
• Consult with Senior Analysts with any questions and/or issues related to claim reviews.
• Assist in content development, automation, research, and appeal responses as needed.
• Provide input and collaboration concerning content development with internal groups and on global projects as needed.
• Attend all required meetings.
• Assists in special projects and perform other duties as needed.

Nurse Itemized Bill Reviewer, IBR Analyst

Manager

• Enhance and Review Clinical Solutions: Utilize expertise to assist in the enhancement and review of readmissions, place of service, and other clinical solutions.
• Collaborative Development: Work with a multi-disciplinary team of programmers, operations staff, product leaders, and auditors to bring DRG process ideas from creation to implementation.
• Regulatory Monitoring: Assess and adjust written rules by monitoring their effectiveness, keeping up with regulatory updates, and making necessary changes.
• Team Leadership: Lead the DRG team by providing guidance, counsel, and development plans to ensure long-term retention and professional growth of DRG staff.
• Claims Review Management: Oversee the entire process of clinical claims review, understanding various client configurations and workflows.
• Operational Oversight: Manage scheduling, reporting to management, issue resolution, and execution of plans.
• Work Coordination: Assign and prioritize work, set goals, and coordinate daily activities of the team. Provide regular updates and communication through one-on-one and team meetings.
• Performance Monitoring: Monitor individual and team results to ensure timely completion of work in accordance with department standards and medical policy guidelines.
• Analytical Problem-Solving: Demonstrate analytical skills to identify problems and trends, develop solutions, and implement action plans.
• Policy and Process Development: Develop departmental policies, processes, and training standards.
• Support and Evidence: Provide internal and external partners with evidence and references supporting industry standards, auditing guidelines, and review stances.
• Performance Reporting: Provide reports on key performance indicators, including quality scores, workflows, savings, revenue projections, and inventory on a predetermined schedule.
• Solution Development: Collaborate with a multi-disciplinary team to suggest solution development, including operations, product, data analytics, and technology.
• Timeline Management: Set timelines and ensure communication on progress, tracking delivery, and escalating roadblocks or dependencies.
• Program Deployment: Design and deploy effective programs/solutions to identify and correct claims with aberrant results, providing feedback to resolve root causes.
• Research and Special Projects: Assist with research, special projects, and ad hoc claim reviews as needed.
• Other Duties: Perform other duties as assigned.

DRG Manager

Chief Technology Officer

• Drive the operating rhythm of the technology organization.
• Own the cadence of quarterly and annual planning cycles including OKRs, budget development, headcount and workforce planning, and resource allocation.
• Track progress against goals, surface risks early, and ensure commitments don’t quietly drift.
• Serve as a trusted thought partner to the CTO.
• Help synthesize complex information into clear recommendations.
• Draft key communications, shape narratives around technical strategy, and ensure the CTO’s time is spent on the highest-leverage activities possible.
• Act as a bridge between engineering and the rest of the business.
• Coordinate with product, finance, HR, and other functions to ensure the technology organization’s plans are integrated with company-wide priorities.
• Partner with finance to manage the technology budget end-to-end.

Chief of Staff to CTO

Operations

• Lead a team responsible for operational execution of data mining and claims review activities
• Oversee day-to-day review operations supporting Medicaid RAC initiatives
• Provide direct supervision, coaching, and performance management for a team
• Ensure that review selections align with approved RAC scopes
• Coordinate closely with analytics, data engineering, quality assurance, and reporting teams
• Support budget adherence and operational forecasting for their team

Manager, Data Mining – Review Operations

• Lead and scale a high-performing team responsible for operational execution of data mining and audit-support activities
• Ensure operational outputs are accurate, consistent, and actionable
• Build, manage, and deliver against annual and ongoing budgets
• Monitor operational spend and ensure the organization meets financial targets
• Collaborate closely with client-aligned stakeholders and internal cross-functional partners
• Continuously improve operational processes and performance through strong metrics discipline

Director of Data Mining Operations, Healthcare Payment Integrity

Content Writer

• Support full lifecycle of proposal development for commercial and government customers, including federal and state procurements, to include RFPs, RFIs, RFQs, and ITB.
• Lead cross-functional proposal teams to meet strict deadlines and ensure compliance with solicitation requirements.
• Ensure proposals meet all technical, legal, and regulatory requirements, including customer-specific guidelines.
• Develop compelling, compliant, and tailored proposal content that clearly articulates Machinify’s value proposition.
• Collaborate with legal, finance, operations, and subject matter experts to gather and synthesize information into cohesive responses.
• Support proposal reviews, approvals, and final submission processes, including electronic portals (e.g., procurement systems).
• Ensure proposal process follows Machinify’s format.
• Maintain proposal content library, including boilerplate content and reusable assets, to improve efficiency and consistency.
• Conduct regular content reviews with subject matter experts in Machinify’s proposal management tool, including post-submittal updates to existing library content as appropriate.
• Ensure confidentiality and compliance with information security protocols throughout the proposal process.

Proposal Writer

• 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.
• Optimize Impact: Measure model performance rigorously, translating outcomes into operational insights and recommendations for our clients.
• Tame Complexity: Work with vast, nuanced data pipelines derived from intricate business workflows—often unclean and undefined—to refine them for robust modeling.
• Drive Team Success: Enhance data pipelines, modeling infrastructure, and team tools to level up our capabilities and decision-making efficiency.
• Grow with Healthcare: Build expertise in healthcare data and make an impact on the industry. Engage with clients and internal experts to refine model insights, ensuring alignment with real business needs.