Machinify

Platform Engineer

• Dig into inherited Scala systems to find where the real problems are, separate symptoms from causes, and make them scale
• Redesign the data layer our ML and AI products depend on — this is an open, hard problem
• Build out a Rust framework that lets teams ship correct, performant services without reinventing fundamentals
• Improve observability and resilience across the platform so we find problems before our customers do
• Shape developer tooling and engineering standards — your work multiplies everyone else's effectiveness
• Drive AI tool adoption across the company, figuring out what actually helps engineers work better
• Work across the full stack: JVM (Java/Scala), Rust, Python, SQL, and Spark

Staff Software Engineer – Platform Team

Auditor

• Auditing claims for medically appropriate services provided for inpatient settings while applying appropriate medical review guidelines, policies and rules.
• Document all findings referencing the appropriate policies and rules.
• Generate letters articulating audit findings.
• Support your findings during the appeals process if requested.
• Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse.
• Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients.
• Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members.
• Cross train in all clinical departments/areas.
• Other duties as required to meet business needs.

Medical Review Nurse – Home Health Auditor

Medical Director

• Provide clinical leadership and medical oversight for audit programs involving governmental and commercial payer claims.
• Review and interpret medical records, claims data, coding patterns, clinical documentation, and payer policies to support accurate audit determinations.
• Evaluate medical necessity, level of care, site of service, coding accuracy, documentation sufficiency, and alignment with applicable clinical standards and payer requirements.
• Support audit methodologies, clinical validation frameworks, sampling approaches, and quality assurance processes to ensure consistency, defensibility, and regulatory alignment.
• Apply knowledge of Medicare, Medicaid, Medicare Advantage, managed care, and commercial payer policies to audit findings, provider education, and client deliverables.
• Partner with audit operations, coding, clinical review, data analytics, compliance, legal, and client-facing teams to resolve complex clinical and payment integrity issues.
• Provide physician-level review and support for disputes, rebuttals, grievances, appeals, and provider-facing clinical explanations.
• Participate in the development and maintenance of clinical audit guidelines, review protocols, policy interpretation tools, and reviewer training materials.
• Monitor regulatory updates, payer policy changes, coding guidance, clinical practice trends, and audit risk areas that may affect governmental or commercial payer work.
• Support client engagements by explaining clinical rationale, audit findings, documentation expectations, and defensible review standards.
• Promote clinical accuracy, reviewer consistency, ethical audit practices, and continuous improvement across medical review operations.
• Other related job duties, as assigned by executive leadership.

Customer Support

• Monitors internal and external reports and take specific actions based on the information
• Responds to client correspondence and email request for information
• Maintains provider information
• Re-prices claims using client contracts and systems
• Creates, documents, and modifies processes for new and existing clients as needed
• Participates in special ad hoc projects and program initiatives as assigned
• Contributes to team effort by completing assigned projects on time
• Receives feedback and adjusts work priority as necessary
• Performs other duties as assigned

Healthcare Operations Support Specialist – SCA

• Work within a team as the primary point of contact for all providers, Medicare contractors, etc.
• Provide professional, accurate and timely responses to CMS (Medicare) and provider inquiries.
• Maintain a current knowledge of all contract requirements and objectives.
• Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors.
• Take inbound calls from providers to answer questions and resolve complex issues.
• Make outbound calls to healthcare providers to confirm if letters requesting records for review have been received.
• Respond to assigned written communications from providers timely and accurately.
• Educate providers on proper process protocols and their appeal rights.
• Establish appropriate contacts and perform necessary research to validate provider contact information.
• Conduct critical due diligence follow-ups if additional research or action is required to resolve an inquiry.
• Enter and update all contact and activity information into tracking logs and the audit platform as necessary.
• Research and route internal/external communications to the appropriate person or department.
• Notify management of all escalated displeasure with the audit program, legal action, government intervention, escalated concerns regarding audit issues and edit parameters, and suggestions to improve or correct processes or documents.
• Perform miscellaneous duties as assigned in a highly professional manner.

Healthcare Customer Service Specialist II

Claims Specialist

• Perform detailed clinical and coding review of facility claims, including review of the detailed itemized statement, the UB-04, and all medical records.
• Assess all clinical aspects of the claim, including the appropriateness of the level of care billed throughout the claim.
• Research client specific medical policies, manufacturer information, clinical and coding guidelines to identify experimental and investigation charges, such as treatments, procedures, and supplies.
• Provide internal and external partners with evidence and references supporting industry standards, auditing guidelines, and review stances.
• Analyze all medication charges to determine correct pharmacy utilization and potential off-label use.
• Review all items billed on an itemized bill in comparison to what is documented in a medical record to determine accuracy from a billing, coding, and clinical perspective.
• Assess the claim for charges related to Do Not Bill Events or Hospital Acquired Conditions.
• Review, expand, and cultivate resources to build up complex claims review content.
• Contribute as a SME to new client initiatives by participating in sales calls and coordinating the completion of test claims.
• Responsible for driving value, including content development, reference expansion, and managing the appeal language for client requested response letters.
• Collaborate and assist in staff training processes and development of training material as needed.
• Comply with company standards regarding productivity and audit accuracy to manage daily assignments and meet client turnaround times.
• Assists in special projects and perform other duties as needed.
• Act as a subject matter expert for the overall product.
• Attends all required meetings.

Complex Clinical Claims Analyst

Analyst

• Investigates and determines whether medical insurance claims are recoverable or non-recoverable from a liable third party
• Communicates and negotiates with healthcare plan members, insurance adjusters, and attorneys
• Utilizes computer systems to accurately document collected information
• Applies organizational, analytical, and time management skills to manage daily workflow
• Reviews and understands healthcare contracts
• Creates medical expense spreadsheets and processes payments from recoveries

Subrogation Analyst

Attorney

• Advises General Counsel on relevant legal issues regarding Subrogation Operations.
• Provides timely and suitable legal review and advice to assigned subrogation recovery team(s).
• Ensures that possible adverse suits and legal matters towards clients and Company are handled appropriately.
• Provides training in relevant legal issues as assigned to new and current analysts.
• Communicates with Subrogation Analysts as needed with information and guidance regarding new court decisions, statutes, and regulations and the potential impact on file handling.

Team Attorney, Subrogation

Data Engineer

• Lead discovery & technical due diligence — get to the bottom of poorly documented legacy systems (ETL, stored procedures, reporting layers, file feeds), reconstruct the business logic, and capture it in the lineage maps, mapping specs, and risk analyses everyone builds from.
• Reverse-engineer complex legacy systems using agents— you will be responsible for reverse-engineering complex, undocumented legacy systems (SSIS packages, stored procedures) where business logic is embedded, not documented. You must be able to reconstruct the intent of these systems to build modern, stable equivalents.
• Drive ambiguity to resolution — spot the unknowns early, own the open questions, and pull answers from clients, SMEs, and Operations instead of waiting to be unblocked.
• Architect & build the migration pipelines — turn intricate legacy logic into production-grade Airflow DAGs and Spark jobs on the Machinify platform, edge cases, payer-specific carve-outs, and business-rule exceptions included, owning the full flow from ingestion through reconciliation to steady-state handoff.
• Make and document the hard architectural calls — own the decisions that matter (pipeline design, partitioning strategy, validation approach) and leave a clear trail of the reasoning so others can learn from and build on it.
• Prove correctness at scale — build automated reconciliation frameworks that confirm, with confidence, that migrated output matches the source down to the row.
• Own the program end to end — be the single technical owner from kickoff through go-live and hypercare: scope, sequence, and track the work, surface risks before they bite, align Operations, Client Success, Platform Engineering, SMEs, and the client, and drive UAT through to sign-off.
• Raise the bar for the practice — Institutionalize migration knowledge by codifying runbooks and retrospectives, mentor L3/L4 engineers to build independent capability, and turn recurring migration pain points into scalable, reusable tooling.

Staff Data Engineer – Core Migrations

Document Specialist

• Manage document workflows, including processing, quality assurance, and adherence to internal procedures.
• Conduct incoming claim reviews, assign statuses, organize data, ensure accuracy, and route files to auditors.
• Collaborate with internal teams to maintain the import queue, reconcile balances, validate charges, correct errors, and manage claim routing.
• Oversee file intake and output, addressing discrepancies, errors, and inquiries.
• Identify and report production environment issues by submitting detailed service tickets.
• Analyze data trends across documents and systems, providing updates on status, claims routing, efficiency, inventory, and volume to relevant teams.
• Monitor file-sharing processes, ensuring data transfer accuracy and appropriate volume levels.
• Perform data entry for itemized bills.
• Complete additional tasks as assigned.

Engineering Manager

• Own the architecture, technical roadmap, and production releases for CORA, holding the team accountable for quality, reliability, and delivery pace
• Stay hands-on through architectural design, code review, and selective coding where it sets the technical bar for the team
• Hire, develop, and retain a team of 5–6 engineers, with deliberate investment in coaching, career growth, and performance management
• Establish the engineering standards, operational practices, and delivery rhythm appropriate to an early-stage greenfield product
• Guide the design of the core rules engine, the claims pipeline, and the AI innovation that moves COB determinations to be more accurate and efficient
• Drive platform decisions for extensibility, scalability, and the security that regulated healthcare data demands as CORA onboards new payers
• Partner with product, ML, UX, and operations to translate evolving payer and analyst requirements into scoped, sequenced work with measurable targets
• Align stakeholders across teams on priorities, tradeoffs, and timelines, and drive cross-functional decisions cleanly to closure
• Define and report the metrics that demonstrate engineering and product impact to leadership and to partner teams across the company
• Represent the team to executive and customer audiences, presenting results and clear articulation of technical strategy

Technical Engineering Manager – COB Product

Data Analyst

• Perform detailed data quality audits to detect, troubleshoot, and resolve issues impacting accuracy and completeness.
• Conduct in-depth analysis of data quality and integrity to identify and resolve issues.
• Create and execute SQL queries to validate data transformations and support data analysis efforts.
• Analyze and troubleshoot ETL processes and data architectures for performance and quality.
• Develop, generate, and maintain client program reports, ensuring accuracy, timeliness, and alignment with client expectations and business objectives.
• Perform detailed data analysis and reconciliation activities to ensure program integrity, including validating outputs against source data and expected results.
• Track and analyze program performance over time, identifying variances, root causes, and trends to ensure accuracy and consistency of results.
• Reconcile data across multiple sources (e.g., claims, eligibility, and reporting outputs) to ensure alignment and completeness.
• Partner with internal teams to investigate discrepancies, implement corrections, and ensure accurate downstream reporting and client deliverables.
• Develop, generate, and maintain recurring and ad hoc reports for both internal stakeholders and external clients, ensuring accuracy, clarity, and timeliness.

Senior Data Analyst

Supervisor

• Monitoring staff and daily recovery efforts.
• Responsible for driving recovery team’s daily productivity, ensuring team is adhering to goals and SLAs.
• Program outreach as required, working with Providers and Networks as needed at the request of team members and Management.
• Effectively collaborates with Management and teams to ensure departmental needs are met.
• Communicates with team to ensure all production goals are clear, understandable, and achievable.
• Work with Leadership to set production goals as needed to meet department expectations.
• Provides feedback coaching and training to team members as required by management.
• Occasional assistance with Audit Concept development and claims review.
• Works with Healthcare Service’s leadership to ensure assigned areas are staffed appropriately to achieve recovery goals.
• Assist in development and revision of team training materials as needed.
• Contribute to development or enhancement or operational and recovery procedures, policies, and tools.
• Advises Leadership of operational training gaps, staff development issues and other observation and areas or opportunity that may involve training.
• Perform other duties as assigned.

Supervisor, HCS Specialty Recovery

Reviewer

• 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.

DRG Reviewer

• Create advanced SQL and Spark SQL expressions for complex calculators, data extractions, and data table construction.
• Troubleshoot and fix SQL issues within complex queries and transformations.
• Own and maintain libraries of clinical calculators and technical reference definitions used across many top 50 payer clients in the country.
• Create data visualizations of medical data points such as glucose levels, mean arterial pressure, and other clinical indicators.
• Use prompt engineering to create advanced prompts for medical record research and extractions.
• Comfortable leveraging Claude / OpenAI to answer complex medical identification questions.
• Troubleshoot and refine prompt logic to improve accuracy and reliability. Clinical Collaboration & Delivery
• Collaborate with medical and clinical staff to create efficiencies in medical case review processes.
• Lead initiatives on advancements in clinical policy building and automation.
• Drive sprints regarding new client launches as they relate to clinical policies and clinical case reviews.
• Collaborate with data science and engineering teams on clinical case needs.