Nurse Itemized Bill Reviewer, IBR Analyst

🕒 April 23

🇺🇸 United States – Remote

💵 $80k - $90k / year

⏰ Full Time

🟢 Junior

🧐 Analyst

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Machinify

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🤖 Artificial Intelligence

☁️ SaaS

💰 $10M Series A - Machinify on 2018-10

Healthcare Insurance • Artificial Intelligence • SaaS

Machinify is a healthcare-focused AI platform and services company that reshapes healthcare payments and payment integrity. Its AI operating system unifies claims, medical records, contracts, and policies, and uses foundation models and task-specific agents to automate and improve coding, payment accuracy, recoveries, and cost avoidance. Machinify serves health plans (including 18 of the top 20), supports insourced, hybrid, or fully-managed deployments, and emphasizes measurable outcomes — reporting 85+ customers, 270M member lives covered, and $6B+ in annual cost avoidance and recoveries.

📋 Description

• 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.

🎯 Requirements

• Active RN, LPN, or LVN license in good standing • Equivalent experience of 1+ years in itemized bill review • Equivalent experience of 2+ years in healthcare billing and coding • Experience applying payer policies and national coding guidelines such as CPT, ICD-9/10, and HCPCS • Ability to research and verify billing and coding accuracy • Possess significant attention to detail and excellent written and verbal skills • Excellent organizational, analytical, and problem-solving skills • Capable of handling multiple projects in a fast paced, hyper-growth environment • Strong ability to work independently and work with internal teams communicating change across the business

🏖️ Benefits

• Work from anywhere in the US! Machinify is digital-first. • Top Medical/Dental/Vision offerings • FSA/HSA • Tuition reimbursement • Competitive salary, 401(k) with company match • Additional health and wellness benefits and perks • Flexible and trusting environment where you’ll feel empowered to do your best work