Remote Healthcare Claims Data Auditor (Pre/Post-Pay)

Machinify; United States; Remote; USD 77,000 - 94,000; Full time

Benefits offered by this job

Remote work (US)

Health benefits

401(k) with company match

Tuition reimbursement

FSA/HSA

Job summary

Machinify is a leading healthcare intelligence company seeking an Auditor for pre and/or post pay data mining to conduct claims audits for customers nationwide. The role supports product testing, quality enhancements, and related tasks to ensure customer satisfaction.

The ideal candidate has 3–5 years of experience in healthcare claims auditing, claims processing, and coding, with strong knowledge of payment guidelines for CMS and commercial payers.

Qualifications

• > 3–5 years of relevant experience.
• "> Ability to review payment information against Medicare and payer billing guidelines to determine payment appropriateness.
• "> Experience or certification in coding/billing is helpful.
• "> Ability to meet deadlines and manage workload.
• "> Strong attention to detail and problem-solving skills.
• "> Proficient in Excel, Word, Gmail, Google Sheets, Slack.

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 other departments.
• Develop and refine reimbursement policies and procedures with the team.
• Remain updated with the latest billing guidelines and regulations.
• Achieve the expected level of accuracy and quality in auditing outcomes.
• Take on additional responsibilities as needed to support the business.

Skills

Attention to detail

Problem solving

Time management

Communication

Tools

Excel

Word

Gmail

Google Sheets

Slack

Job description

Machinify is a leading healthcare intelligence company seeking an Auditor for pre and/or post pay data mining to conduct claims audits for customers nationwide. The role supports product testing, quality enhancements, and related tasks to ensure customer satisfaction.

The ideal candidate has 3–5 years of experience in healthcare claims auditing, claims processing, and coding, with strong knowledge of payment guidelines for CMS and commercial payers.