Senior Content Innovation Lead - Claims Editing & AI

Machinify; United States; Remote; USD 110.000 - 160.000; Vollzeit

Zusammenfassung

Machinify is a healthcare intelligence company that uses an AI-powered platform to maximize financial outcomes and reduce healthcare costs for health plans. Deployed by over 85 health plans representing more than 270 million lives, it fosters a culture of innovation, transparency, and efficiency.

We are seeking a Senior Claims Content Editor who will source and edit content, collaborate with Product and Data Science, and drive measurable improvements in content quality and client value.

Qualifikationen

• 7+ years in claims editing, clinical coding, Payment Integrity, or payer policy.
• Active coding credential such as CPC, CCS, CCS-P, CPMA, or CIC, or a clinical license with deep coding knowledge.
• Strong analytical skills using SQL or Excel, and clear communication for both clinical and nonclinical audiences.

Aufgaben

• Source and author editing content, monitoring authoritative sources like CPT, HCPCS, ICD-10-CM, NCCI, and CMS manuals.
• Use claims data to test editing concepts, size opportunities, and track metrics like hit rate, false positives, and savings.
• Partner with Product and Data Science to translate content into requirements and apply AI tools to improve content building.

Kenntnisse

Claims editing

Clinical coding

Payment Integrity

Payer policy

SQL

Excel

Communication

AI tools

Ausbildung

CPC/CCS/CCS-P/CPMA/CIC or clinical license

Tools

AI platforms

Jobbeschreibung

Machinify is a healthcare intelligence company that uses an AI-powered platform to maximize financial outcomes and reduce healthcare costs for health plans. Deployed by over 85 health plans representing more than 270 million lives, it fosters a culture of innovation, transparency, and efficiency.

We are seeking a Senior Claims Content Editor who will source and edit content, collaborate with Product and Data Science, and drive measurable improvements in content quality and client value.