Remote Policy & Content Architect – Payment Integrity

Rawlings Company; United States; Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Remote-friendly, US-wide

Medical/Dental/Vision

FSA/HSA

Tuition reimbursement

401(k) with company match

Wellness benefits

Flexible work environment

Job summary

Machinify, a leading healthcare intelligence company, seeks an IBR Policy and Content Development Analyst to lead the creation and enhancement of clinical and coding solutions. You will act as the SME for payment integrity policies, translating regulations into clear policy documentation and ensuring alignment with coding standards and payer policies.

In this role, you will collaborate with operations, clinical, client services, and IT, review audit concepts, embed state-specific requirements,

Qualifications

• 3+ years' experience in payment integrity or auditing facility claims.

Responsibilities

• Review and update audit concepts regularly and after regulatory changes.

Skills

Payment integrity

Auditing facility claims

Policy development

Regulatory knowledge

Medicare/Commercial coding rules

Client-ready communication

Analytical thinking

AI tools / automation

Cross-functional collaboration

Prioritization & multitasking

Education

RHIA, RHIT, CCS, CPC, CPMA

Active RN/LPN License

Tools

Microsoft Office

SharePoint

Teams

Job description

Machinify, a leading healthcare intelligence company, seeks an IBR Policy and Content Development Analyst to lead the creation and enhancement of clinical and coding solutions. You will act as the SME for payment integrity policies, translating regulations into clear policy documentation and ensuring alignment with coding standards and payer policies.

In this role, you will collaborate with operations, clinical, client services, and IT, review audit concepts, embed state-specific requirements,