Claims Administrator

Machinify · Remote - US

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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 

 

What experience you bring (Role Requirements) 

 

What Success Looks Like… 

After 3 months  

After 1 year 

 

Pay range: $24.00 USD per hour. This is a non-exempt position. 

 

What’s in it for you          

 

What values we’ll share with you 

 

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: https://www.machinify.com/candidate-privacy-notice/
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