Machinify is a healthcare AI platform and services company focused on improving payment integrity for health plans. Its AI operating system brings together claims, medical records, contracts, and policies, combining foundation models with task-specific agents to support coding, payment accuracy, recoveries, and cost avoidance. Machinify offers insourced, hybrid, and fully managed deployments, serving 85+ customers and covering 270 million member lives. The company reports more than $6 billion in annual cost avoidance and recoveries.
Remote Claims Coordinator - United States
Process healthcare claims remotely for Machinify’s AI-powered health plan platform. Review documents, enter claim data, route files, and maintain HIPAA-compliant processing.
Description
- Monitor incoming claim notifications and confirm that all required documents are complete and legible.
- Verify that required submission documents are present and readable.
- Set up claims, enter data accurately, and assign the appropriate claim statuses.
- Conduct initial reviews of client-submitted claims, EOBs, bills, policies, correspondence, and related documents.
- Combine and extract claim documents as needed.
- Copy combined files and rename them in accordance with established policies and procedures.
- Enter UB-04 data for analysts.
- Route claim documents to the Document Management and IBR departments.
- Prepare appeal letters and return them to clients.
- Review client-provided coversheets to confirm accurate reimbursement.
- Update the system to reflect correct reimbursement and savings.
- Escalate problematic claims to the Lead of Claim Processing.
- Alert the Lead of Claim Coordinator when documents are missing or illegible.
- Maintain compliance with HIPAA and other security requirements.
- Complete additional duties as assigned.
Requirements
- Type at least 40 words per minute.
- Demonstrate strong, highly accurate data-entry skills.
- Possess intermediate to advanced computer skills, including proficiency with Microsoft Office Suite and Adobe Acrobat.
- Comfortably work across multiple monitors.
- Learn company-specific software quickly.
- Maintain exceptional attention to detail.
- Apply strong organizational, analytical, and critical-thinking skills.
- Demonstrate strong interpersonal and team-building abilities.
- Collaborate effectively across diverse teams and support change across functional and business boundaries.
Benefits
- Paid time off, paid holidays, and volunteer days.
- Eligibility for health, vision, and dental coverage.
- Participation in a 401(k) plan with company matching.
- Flexible spending accounts.
- Tuition reimbursement.
- Company-paid life insurance.
- Company-paid short-term disability coverage.
- Company-paid parental leave.
- Remote and hybrid work options.