Machinify, Inc.
Artificial Intelligence • Healthcare Insurance • Fintech
Machinify, Inc. is a company specializing in artificial intelligence solutions for the healthcare industry, particularly in optimizing payment processes and enhancing payment integrity. Their product suite, including Machinify Audit and Machinify Pay, is designed to automate and improve the accuracy of medical claims review, identifying billing and coding errors, and reducing administrative costs. Machinify's AI-driven platform covers millions of healthcare members and delivers significant financial benefits by efficiently processing medical claims and empowering health plans to tailor their policies. With a focus on transparency, control, and safety in AI, Machinify offers customized solutions that adapt to the specific needs of healthcare providers and contribute to the transformation of healthcare payments.
51 - 200 employees
🤖 Artificial Intelligence
⚕️ Healthcare Insurance
💳 Fintech
💰 $10M Series A on 2018-10
DRG Clinical Validation Director
Job not on LinkedIn
October 24
Machinify, Inc.
Artificial Intelligence • Healthcare Insurance • Fintech
Machinify, Inc. is a company specializing in artificial intelligence solutions for the healthcare industry, particularly in optimizing payment processes and enhancing payment integrity. Their product suite, including Machinify Audit and Machinify Pay, is designed to automate and improve the accuracy of medical claims review, identifying billing and coding errors, and reducing administrative costs. Machinify's AI-driven platform covers millions of healthcare members and delivers significant financial benefits by efficiently processing medical claims and empowering health plans to tailor their policies. With a focus on transparency, control, and safety in AI, Machinify offers customized solutions that adapt to the specific needs of healthcare providers and contribute to the transformation of healthcare payments.
51 - 200 employees
🤖 Artificial Intelligence
⚕️ Healthcare Insurance
💳 Fintech
💰 $10M Series A on 2018-10
📋 Description
• The DRG Clinical Validation Director is responsible for the development and management of our DRG clinical validation solutions. • Implement integration support, client support, and assistance to various teams within the organization related to clinical validation. • Lead the DRG Clinical Validation team by providing guidance, counsel, and development plans. • Oversee the entire process of clinical claims review and manage scheduling, reporting to management, issue resolution, and execution of plans.
🎯 Requirements
• Bachelor’s degree (health administration, business, nursing) • Equivalent experience of 5+ years in healthcare billing and coding • Equivalent experience of 3+ years in claims auditing and recovery auditing • Nursing license required • Required certifications of CCDS or CDIP • Previous supervisory experience required • Proven experience working within a team • Strong experience in data utilization and insights • Ability to work efficiently and effectively with minimal supervision • High standards of quality and attention to detail.
🏖️ Benefits
• PTO, Paid Holidays, and Volunteer Days • Eligibility for health, vision and dental coverage • 401(k) plan participation with company match • Flexible spending accounts • Tuition Reimbursement • Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave. • Remote and hybrid work options
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