Remote Post-Acute Audit Policy Specialist

Rawlings Company; United States; On-site; USD 90,000 - 120,000; Full time

Job summary

Machinify is seeking an Audit Policy Analyst, Post-Acute Services to lead post-acute payment integrity audit concepts for DME, home health, and home infusion claims. You will partner with operations, clinical, client services, and technology teams to ensure concepts are built, validated, and maintained per coding standards and payer policies.

Ideal candidates bring expertise in DME MAC policy, PDGM, and home infusion benefits, with strong analytic and mentoring capabilities to guide a team of

Qualifications

• Bachelor's degree requirement; healthcare and policy background helpful.
• Experience in DME, home health and infusion therapy a plus.
• Strong analytical and communication skills; ability to mentor a team.

Responsibilities

• Develop and maintain post-acute audit concepts for DME, home health, and home infusion therapy claims.
• Review and update audit concepts per regulatory changes and payer policy updates.
• Validate audit logic against post-acute billing rules and payer policies before deployment.
• Manage multiple audit concept workflows with accuracy and timely delivery.
• Create training materials and reference tools for post-acute audit concepts.
• Support client services with policy explanations and audit concept guidance.
• Monitor performance and analytics to drive improvements in audit concepts.

Education

Bachelor's degree in nursing, health administration, business, or a related field, or equivalent experience

Job description

Machinify is seeking an Audit Policy Analyst, Post-Acute Services to lead post-acute payment integrity audit concepts for DME, home health, and home infusion claims. You will partner with operations, clinical, client services, and technology teams to ensure concepts are built, validated, and maintained per coding standards and payer policies.

Ideal candidates bring expertise in DME MAC policy, PDGM, and home infusion benefits, with strong analytic and mentoring capabilities to guide a team of