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Machinify, Inc.

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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

• Oversee the quality assurance of DRG Reviewers, ensuring adherence to clinical, coding, and organizational standards • Audit the work of both new hires and current staff • Conduct training to ensure team members are equipped with the knowledge and skills needed to succeed • Provide detailed feedback and collaborate on training initiatives • Foster a culture of continuous learning and improvement • Review and audit the work of new and existing DRG Reviewers • Provide constructive, detailed feedback to DRG Reviewers • Assist the educator by conducting supplemental training sessions and ongoing training to existing staff • Maintain comprehensive documentation of audit findings, feedback sessions, and training activities • Generate reports on the quality assurance results and the effectiveness of training sessions

🎯 Requirements

• Associate or bachelor’s degree in nursing, health information management, or a related field • RHIA - Registered Health Information Administrator • RHIT - Registered Health Information Technician • CCDS - Certified Clinical Documentation Specialist • CDIP - Clinical Documentation Improvement Practitioner • CCS - Certified Coding Specialist • 2+ years of experience in inpatient claims auditing, quality assurance, or clinical documentation integrity • 1+ year of experience in a training or mentoring capacity • Strong knowledge of DRG methodologies (MS & APR), ICD-10-CM/PCS coding, and UHDDS definitions • Proficient in Windows office systems, including the full Microsoft Suite and Teams • Advanced skills in Microsoft Office (Excel, PowerPoint, Word)

🏖️ 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