Staff Data Scientist – Fraud, Billing

🕒 February 25

🇺🇸 United States – Remote

⏰ Full Time

🔴 Lead

📊 Data Scientist

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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

• Build and ship classical ML and GenAI pipelines that surface, rank, and explain candidate billing error, audit, and fraud concepts across large-scale healthcare claims data • Advance state-of-the-art research in anomaly detection, information retrieval, and weak supervision, turning research into robust production systems • Accelerate concept generation and concept validation with SMEs by designing human-in-the-loop workflows that enable high-throughput review with strong precision, recall, and traceability • Own end-to-end delivery from problem framing and data strategy to model development, evaluation, deployment, and monitoring, with a focus on reliability and customer outcomes • Partner cross-functionally with Product, Data Engineering, Operations, SMEs, and business leaders to prioritize work, unblock execution, and unlock material financial value • Help scale the team and platform as Machinify grows aggressively toward resale and IPO readiness

🎯 Requirements

• Degree in Computer Science, Engineering, or a related field • 10+ years of data science experience, with at least 5 years in a leadership role, including a leadership role at a start-up. Proven track record of managing data teams and delivering complex, high-impact products from concept to deployment • Strong knowledge of data privacy regulations and best practices in data security • Exceptional team management abilities, with experience in building and leading high-performing teams • Ability to think strategically and execute methodically • Ability to drive change and inspire a distributed team • Strong problem-solving skills and a data-driven mindset • Ability to communicate effectively, collaborating with diverse groups to solve complex problems • You embrace challenges with optimism and a balanced, and bring a business-oriented approach to product development • You prioritize customer impact, ensuring your work significantly advances our product value

🏖️ 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 • Unlimited PTO • Additional health and wellness benefits and perks • Flexible and trusting environment where you’ll feel empowered to do your best work