Remote Healthcare Claims Data Auditor

Rawlings Company; La Grange (KY); Remote; USD 77,000 - 94,000; Full time

Benefits offered by this job

Work from anywhere in the US

Top Medical/Dental/Vision offerings

FSA/HSA

Tuition reimbursement

401(k) with company match

Additional health and wellness perks

Job summary

Machinify is seeking an Auditor to perform pre- and post-pay data mining for claims audits on behalf of our healthcare clients. The role supports product testing, quality improvements, and customer satisfaction across payer guidelines and CMS requirements.

You will review payments, identify valid claims, and help refine reimbursement policies in a fast-paced setting. Proficiency in Excel, Word, Gmail, Google Sheets, Slack, and related tools is essential.

Qualifications

• 3–5 years of relative experience in healthcare claims auditing or related field.
• Ability to review payment information against Medicare and payer guidelines.
• Experience or certification in coding/billing is helpful.
• Ability to meet deadlines and handle workload demands.
• Strong problem-solving and investigative abilities; attention to detail.

Responsibilities

• Conduct comprehensive reviews of pre and post pay claims using available resources.
• Serve as a claims billing and payment expert for data teams and departments.
• Develop and refine reimbursement policies with the team.
• Stay updated with latest billing guidelines and regulations.
• Ensure accuracy and quality in audit documentation.

Skills

Attention to detail

Problem-solving

Deadline-oriented

Data analysis

Team collaboration

Education

Coding/billing certification

Tools

Excel

Word

Gmail

Google Sheets

Slack

Job description

Machinify is seeking an Auditor to perform pre- and post-pay data mining for claims audits on behalf of our healthcare clients. The role supports product testing, quality improvements, and customer satisfaction across payer guidelines and CMS requirements.

You will review payments, identify valid claims, and help refine reimbursement policies in a fast-paced setting. Proficiency in Excel, Word, Gmail, Google Sheets, Slack, and related tools is essential.