Claims Coordinator

The Rawlings Group; United States; Hybrid; USD 17,000 - 24,000; Full time

Benefits offered by this job

PTO and holidays

Health, vision & dental coverage

401(k) plan with match

Tuition reimbursement

Life insurance

Job summary

Machinify is seeking a Claims Coordinator to handle accurate, timely processing of healthcare claims. You will review notifications, verify documents, and set up claims in the system while escalating issues per policy. HIPAA and security standards govern daily workflow.

The role requires strong data entry, 40 WPM, and proficiency with MS Office; remote or hybrid work options are available to accommodate diverse teams.

Qualifications

• Minimum typing speed of 40 WPM.
• Strong data entry skills with high accuracy.
• Proficient with Microsoft Office and Acrobat.
• Good multitasking across several monitors.
• Detail-oriented and organized, with analytical thinking.
• Collaborates well across diverse teams.

Responsibilities

• Monitor incoming claim notifications and ensure all documents are complete and legible.
• Verify all required submission documents are present and legible.
• Perform initial claim setup, enter data, and assign claim statuses.
• Analyze data and documents submitted by clients (claims, EOBs, bills).
• Transfer claim documents to relevant departments and assist with adjustments.
• Create appeal letters and return to clients, ensuring accuracy.
• Ensure HIPAA compliance and security standards throughout processing.
• Support other duties as assigned.

Skills

40 WPM typing

Data entry

MS Office Suite

Adobe Acrobat

Multiple monitors

Learn new software quickly

Attention to detail

Team collaboration

Tools

Microsoft Office

Adobe Acrobat

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

About the Opportunity

At Machinify, we're constantly reimagining what's possible in our industry-creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow.

The Claims Coordinator handles the accurate and timely processing of healthcare claims. This role reviews notifications, checks documents for completeness, sets up claims in the system, and routes them to the right departments. The coordinator escalates problem claims, communicates missing information, and follows HIPAA and security standards to support a smooth claims review process.

What you'll do

• Monitor incoming claim notifications and ensure all required documents are complete and legible.
• Verifying all required submission documents are present and legible.
• Perform initial claim setup, accurately enter data, and assign correct claim statuses.
• Perform initial analysis of data and documents submitted by the client such as claims, EOBs, bills, policies, correspondence, etc.
• Combine and Extract claim documents when needed.
• Copy combined file and rename according to policy and procedures.
• Enter UB04 data information for analyst.
• Transfer claim documents to Document Management and IBR departments.
• Create appeal letters and return to client.
• Analyzes the client provided coversheet for correct reimbursement.
• Adjust system to reflect the correct reimbursement and savings.
• Escalate claims with problems to Lead of claim processing.
• Notify Lead of Claim Coordinator when documents are missing or illegible.
• Maintain compliance with HIPAA and other security requirements.
• Performs other duties as assigned.

What experience you bring (Role Requirements)

• Minimum typing speed of 40 WPM
• Strong data entry skills with a high degree of accuracy
• Intermediate to advanced computer proficiency, including Microsoft Office Suite, Adobe Acrobat, working across multiple monitors, and the ability to quickly learn company-specific software
• Exceptional attention to detail, with strong organizational, analytical, and critical thinking skills
• Strong interpersonal and team-building skills, with the ability to collaborate across a diverse team and drive change across functional and business boundaries

Pay range

This is a non-exempt position at $15.00/hour.

What's in it for you

• PTO, Paid Holidays, and Volunteer Days
• Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts
• Tuition Reimbursement
• Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.
• Remote and hybrid work options

What values we'll share with you

• Ask why
• Think big
• Be humble
• Optimize for customer impact
• Deliver results

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/