Senior Data Analyst

🕒 July 28

🇺🇸 United States – Remote

💵 $140k - $170k / year

⏰ Full Time

🟠 Senior

📉 Data Analyst

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Machinify

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

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

Healthcare • Consulting • Logistics

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

• Collaborate with clients and internal stakeholders to understand payment integrity requirements, document process flows, and integrate analytical outputs with client workflows and downstream adjudication systems • Develop deep understanding of Machinify's internal processes and how they integrate together — from data ingestion through claims adjudication — ensuring analytical solutions are accurate, traceable, and aligned with business needs • Actively drive AI adoption: prompt and iterate with LLMs to accelerate analysis, identify processes where AI can replace manual workflows, and contribute to AI-assisted pipeline development • Write and maintain complex analytical SQL against large-scale claims datasets: window functions, CTEs, multi-table joins, query optimization, and production-quality logic that runs reliably at scale • Identify and build AI-driven automation workflows that replace or accelerate manual analytical processes — moving from one-off prompts to repeatable, team-shareable tooling • Design and implement data transformations that convert raw medical and institutional claims into canonical models, applying healthcare coding standards (ICD-10, CPT, HCPCS, UB-04, CMS-1500) throughout • Drive payment integrity analysis — identify overpayment patterns, coordination of benefits issues, and billing edit opportunities by applying deep knowledge of payer policy, CMS regulations, and provider reimbursement methodologies • Conduct data quality audits and build monitoring frameworks that surface anomalies before they reach production • Support onboarding of new client data feeds, ensuring smooth integration with minimal disruption • Partner with engineers, clinical staff, and product managers to translate complex healthcare requirements into data solutions • Mentor analysts and engineers on healthcare domain questions — serving as the go-to SME on coding, claims adjudication, and payer policy • Document transformation logic, data lineage, and analytical methodologies to support knowledge transfer and audit readiness.

🎯 Requirements

• 5+ years of data analysis experience and working directly with healthcare claims data • Deep knowledge of medical claim types (professional and institutional), coding systems (ICD-10-CM/PCS, CPT, HCPCS), and standard form formats (UB-04, CMS-1500) • Demonstrated experience using LLMs or AI tools to accelerate analytical work — not as a novelty, but as a repeatable part of your workflow • Expert-level SQL: complex analytical queries, window functions, CTEs, performance tuning against datasets of hundreds of millions of rows • Hands-on payment integrity experience: overpayment detection, COB, billing edits, or claim editing logic • Familiarity with CMS regulations and commercial payer guidelines as they apply to claims adjudication and payment policy • Strong communicator — able to discuss healthcare process and payment logic directly with health plan clients and non-technical stakeholders • Ability to translate ambiguous business and clinical requirements into precise, well-documented data logic • Working knowledge of provider reimbursement methodologies — MS-DRG/APR-DRG pricing, fee schedules, per diem, and capitation • Proficiency with Spark SQL or a comparable distributed query engine — writing and optimizing queries against large-scale data environments is a daily expectation • Experience with Databricks or a cloud data lakehouse (Delta Lake, Snowflake, BigQuery) • Background in ETL/ELT pipeline development or close collaboration with data engineers on pipeline design • Exposure to value-based care arrangements or risk adjustment (HCC coding, RADV) • Prior experience at a health plan, payment integrity vendor, or healthcare analytics firm.

🏖️ Benefits

• Work from anywhere in the US! Machinify is digital-first. • Full Medical/Dental/Vision for employees & their families • Flexible and trusting environment where you’ll feel empowered to do your best work • Unlimited FTO • Competitive salary, equity, 401(k) including employer match