Healthcare Reimbursement Data Analyst

Machinify; United States; Remote; USD 80,000 - 90,000; Full time

Benefits offered by this job

Remote-friendly

Medical/Dental/Vision

401(k) match

FSA/HSA

Flexible environment

Job summary

Machinify, a leading healthcare intelligence company, is seeking an Analyst to help develop and refine reimbursement and payment integrity concepts. This is a hands-on healthcare domain role focused on understanding reimbursement logic, contracts, and payer rules.

You’ll investigate payment errors, design detection methods, and partner with engineering to operationalize insights. The role suits someone who enjoys claims data, root-cause analysis, and translating policy into actionable analytics.

Qualifications

• 2+ years in healthcare data mining or claims editing.
• Deep understanding of provider contracts, rate structures, and reimbursement methods.
• Experience with CMS and commercial payer payment rules.
• Strong investigative and deductive reasoning skills.
• Ability to translate policy and data into actionable insights.

Responsibilities

• Lead pre and post-pay claim reviews to identify inaccurate payments.
• Analyze and interpret provider contracts to ensure payments align with terms, methodologies, and payer rules.
• Collaborate with engineering and data science to translate business and reimbursement logic into analytical and automation frameworks.
• Analyze claim-level data to pinpoint root causes of overpayments or incorrect denials and recommend corrective approaches.
• Maintain expertise on CMS and commercial payer reimbursement guidelines.
• Support quality review, concept validation, and process improvement initiatives.

Skills

Healthcare data mining

Claims editing

Provider contracts

CMS payer rules

Analytical reasoning

Cross-functional collaboration

Detail-oriented

Job description

Machinify, a leading healthcare intelligence company, is seeking an Analyst to help develop and refine reimbursement and payment integrity concepts. This is a hands-on healthcare domain role focused on understanding reimbursement logic, contracts, and payer rules.

You’ll investigate payment errors, design detection methods, and partner with engineering to operationalize insights. The role suits someone who enjoys claims data, root-cause analysis, and translating policy into actionable analytics.