<div class="content-intro"><p><span style="color: rgb(0, 0, 0);">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.</span></p></div><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><strong>About the Opportunity</strong></span></p><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">At Machinify, we’re constantly reimagining what’s possible in our industry—creating disruptively simple, powerfully clear ways to maximize our clients’ financial outcomes today and drive down healthcare costs tomorrow. As part of the Complex Payment Solutions team, you will, as a <strong>Nurse</strong> <strong>Itemized Bill Reviewer (IBR Analyst)</strong>, be responsible for reviewing facility insurance claims to determine true and accurate charges. This role requires the analysis of the UB-04, the detailed itemized statement, and medical documentation when provided. The analyst will apply the client policy and industry standards when reviewing these claims. This role must identify billed items and services that do not meet the appropriate compliance guidelines. This role requires clinical expertise, as well as previous itemized bill review experience.</span></p><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><strong>What you’ll do</strong></span></p><ul><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Perform an in-depth review of medical claims utilizing the UB-04 and detailed itemized statement to ensure the validity of line-item charges.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Verify accuracy of the itemized charges to be reimbursed according to client policy and industry standards.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Validate automatic system denials and create additions to enhance efficient processing of IBR claims.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Recommend system enhancements and edits to improve claim review efficiency.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Comply with company standards regarding accuracy and productivity to manage daily assignments and meet client turnaround times.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Consult with Senior Analysts with any questions and/or issues related to claim reviews.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Assist in content development, automation, research, and appeal responses as needed.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Provide input and collaboration concerning content development with internal groups and on global projects as needed.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Attend all required meetings.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Assists in special projects and perform other duties as needed.</span></li></ul><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><strong>What experience you bring (Role Requirements)</strong></span></p><ul><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Active RN, LPN, or LVN license in good standing</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Equivalent experience of 1+ years in itemized bill review</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Equivalent experience of 2+ years in healthcare billing and coding</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Experience applying payer policies and national coding guidelines such as CPT, ICD-9/10, and HCPCS </span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Ability to research and verify billing and coding accuracy</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Possess significant attention to detail and excellent written and verbal skills</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Excellent organizational, analytical, and problem-solving skills</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Capable of handling multiple projects in a fast paced, hyper-growth environment</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Strong ability to work independently and work with internal teams communicating change across the business</span></li></ul><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><strong>Computer Equipment and Software:</strong></span></p><ul><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Experience working with multiple monitors</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Proven success in a remote working environment</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Proficient in Windows office systems, including the full Microsoft Suite and Teams</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Advanced skills in Microsoft Office (Excel, PowerPoint, Word)</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: rgb(0, 0, 0);">Experience with various software applications and collaboration with development teams</span></li></ul><div><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong>What We Offer:</strong></span></div><ul><li style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">Work from anywhere in the US! Machinify is digital-first.</span></li><li style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><div><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">Top Medical/Dental/Vision offerings</span></div></li><li style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><div><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">FSA/HSA</span></div></li><li style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><div><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">Tuition reimbursement</span></div></li><li style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><div><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">Competitive salary, 401(k) with company match</span></div></li><li style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><div><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">Additional health and wellness benefits and perks</span></div></li><li style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">Flexible and trusting environment where you’ll feel empowered to do your best work</span></li></ul><div><span style="color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 12pt;">The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. </span></div><div> </div><div><span style="color: rgb(0, 0, 0); font-size: 12pt; font-family: arial, helvetica, sans-serif;">Pay range: $80,000 - $90,000, with the opportunity to earn quarterly bonuses.</span></div><div> </div><div class="content-conclusion"><div><span style="color: rgb(0, 0, 0);"><strong>Equal Employment Opportunity at Machinify</strong></span></div><div> </div><div><span style="color: rgb(0, 0, 0);">We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: <u><a id="m_4907613542122963413OWAae7934b9-fa06-3f98-e336-0c5f8a6d5638" style="color: rgb(0, 0, 0);" href="https://www.machinify.com/candidate-privacy-notice/" target="_blank" data-saferedirecturl="https://www.google.com/url?q=https://www.machinify.com/candidate-privacy-notice/&source=gmail&ust=1763168899816000&usg=AOvVaw0FJrzi47RtxTK_RN63lbaj">https://www.machinify.com/candidate-privacy-notice/</a></u></span></div></div>