索赔管理员
Claims Administrator
Machinify 是一家领先的医疗健康智能公司，拥有贯穿支付全流程的专业知识，为全国的医保客户带来无与伦比的价值、透明度和效率。Machinify 已被超过 85 家医保机构部署，包括许多排名前 20 的机构，覆盖超过 2.7 亿人口。Machinify 结合了完全可配置且内容丰富的 AI 驱动平台以及行业一流的专家团队。我们不断重新定义行业可能性，创造简单而强大的方式，最大化客户的财务成果并降低医疗成本。
职位介绍
在 Machinify，我们不断重新定义行业可能性——创造颠覆性的简单方式，清晰有力地提升客户当前的财务成果，并降低未来的医疗成本。作为复杂支付解决方案团队的一员，你将担任理赔管理员，负责支持高效的理赔处理，并确保在整个审核和审计过程中数据准确。该职位涉及对收到的理赔进行审查，整理数据，分配状态，并将完成的文件路由给审计人员，同时保持文档整洁并遵守内部流程。
该职位需要与内部团队密切合作，管理导入队列，核对余额，验证费用，识别并解决错误，并促进理赔路由。理赔管理员 I 负责文件的输入和输出，回应查询，解决差异，并确保有关理赔的有效沟通。
此外，该职位还包括分析数据趋势，监控文件共享流程，验证数据传输准确性，并确保适当的处理量水平。文档录入和其他行政任务也是该职位的重要组成部分。
理想的候选人具备出色的时间管理能力、细致的注意力和在动态环境中协作工作的能力。
工作职责
- 审查收到的理赔，分配状态，整理数据，并将文件路由给审计人员。
- 与团队协作，管理导入队列，核对余额，验证费用，纠正错误，并路由文件。
- 监督文件的输入和输出，处理查询、差异和错误。
- 分析数据趋势，并就理赔路由、效率、库存和处理量进行沟通更新。
- 监控文件共享流程，确保数据传输准确。
查看英文原文
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
About the Opportunity
At Machinify, we’re constantly reimagining what’s possible in our industry—creating disruptively simple, powerfully clear ways to maximize our clients’ financial outcomes today and drive down healthcare costs tomorrow. As part of the Complex Payment Solutions Team, you will, as a Claims Administrator, be responsible for supporting efficient claims processing and ensuring data accuracy throughout the review and auditing process. This role involves performing incoming claim reviews, organizing data, assigning statuses, and routing completed files to auditors while maintaining document hygiene and adhering to internal procedures.
The position requires close collaboration with internal teams to manage import queues, reconcile balances, validate charges, identify, and address errors, and facilitate claims routing. The Claims Administrator I oversees the intake and output of files, responding to inquiries, resolving discrepancies, and ensuring effective communication regarding claims.
Additionally, this role includes analyzing data trends, monitoring file-sharing processes, verifying data transfer accuracy, and ensuring appropriate volume levels are maintained. Data entry of documents and other administrative tasks are also integral to the position.
The ideal candidate demonstrates strong organizational skills, attention to detail, and the ability to work collaboratively in a dynamic environment.
What you’ll do
- Review incoming claims, assign statuses, organize data, and route files to auditors.
- Collaborate with teams to manage the import queue, reconcile balances, validate charges, correct errors, and route files.
- Oversee file intake and output, addressing inquiries, discrepancies, and errors.
- Analyze data trends and communicate updates on claims routing, efficiency, inventory, and volume.
- Monitor file-sharing processes, ensure data transfer accuracy, and maintain appropriate volume levels.
- Perform data entry and support additional administrative tasks as needed.
What experience you bring (Role Requirements)
- Preferred experience in medical record review and knowledge of medical terminology.
- Proficient in Microsoft Office Suite, Adobe Acrobat, and multi-monitor setups; adaptable to company-specific software.
- Strong attention to detail, organizational, analytical, and critical thinking skills.
- Excellent interpersonal and teamwork abilities, capable of collaborating across functions and driving change.
What Success Looks Like…
After 3 months
- You will have a strong understanding of the role.
- You begin building relationships and collaborating with peers.
- You develop effective time and priorities management.
- You receive initial feedback about your performance and are using it to improve.
- You’ve gained confidence in your abilities and are starting to feel more comfortable in your role.
After 1 year
- You have mastered the tasks and responsibilities of the position, executing them with confidence and efficiency.
- You have established a strong network of internal relationships and are recognized as a key collaborator.
- You’ve been entrusted with greater responsibility indicating the company’s confidence in your abilities.
- You see opportunities for career progression and personal development.
Pay range: $24.00 USD per hour. This is a non-exempt position.
What’s in it for you
- PTO, Paid Holidays, and Volunteer Days
- Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts
- Tuition Reimbursement
- Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.
- Remote and hybrid work options
What values we’ll share with you
- Ask why
- Think big
- Be humble
- Optimize for customer impact
- Deliver results
Equal Employment Opportunity at Machinify
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at:
Originally posted on Himalayas