Machinify

Role Description The Healthcare Specialty Recovery Supervisor is a highly skilled, talented medical billing, revenue specialist with a strong knowledge of medical claims billing and recovery. They will play a key role in continual improvement of recovery processes, procedures, and staff development. - Monitoring staff and daily recovery efforts. - Responsible for driving recovery team’s daily productivity, ensuring team is adhering to goals and SLAs. - Program outreach as required, working with Providers and Networks as needed at the request of team members and Management. - Effectively collaborates with Management and teams to ensure departmental needs are met. - Communicates with team to ensure all production goals are clear, understandable, and achievable. - Work with Leadership to set production goals as needed to meet department expectations. - Provides feedback coaching and training to team members as required by management. - Occasional assistance with Audit Concept development and claims review. - Works with Healthcare Service’s leadership to ensure assigned areas are staffed appropriately to achieve recovery goals. - Assist in development and revision of team training materials as needed. - Contribute to development or enhancement of operational and recovery procedures, policies, and tools. - Advises Leadership of operational training gaps, staff development issues and other observations and areas of opportunity that may involve training. - Perform other duties as assigned. Qualifications - Working knowledge of recovery and revenue cycle management. - Strong knowledge of Medicare requirements and regulations. - Proficient in MS Office, MS Word, PowerPoint, and Excel. - Strong communication skills, both verbal and written, to assist recovery agents with escalated Provider and Network communications. - Ability to manage multiple tasks and priorities to meet department deadlines and expectations. - Proven experience in developing and maintaining a high performing production team. - Strong interpersonal skills that lead to positive interactions with staff, peers, leadership, and stakeholders. - Self-motivated, thrives in a fast-paced office environment while performing multiple tasks cohesively, with keen attention to detail. - Ability to work full-time and on-site or remote as needed to meet business needs. - Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs. - Ability to lead group activities and discussions that result in effective knowledge transfer, development, and desired business outcomes. - Strong critical thinking and problem-solving skills. Requirements - High School Diploma or GED required. - Bachelor’s degree in relevant field or equivalent combination of education and experience. - 3+ years of Revenue cycle or Recovery experience. - 3+ years in a Healthcare claims or revenue cycle management environment. - 2+ years supervisory experience in fast-paced production or call center environment. - Some college or training in medical terminology, billing, coding, or medical billing/Coding certificate. - Extensive experience with provider outreach and communication. Benefits - Work from anywhere in the US! Machinify is digital-first. - Top Medical/Dental/Vision offerings. - FSA/HSA. - Tuition reimbursement. - Competitive salary, 401(k) with company match. - Additional health and wellness benefits and perks. - Flexible and trusting environment where you’ll feel empowered to do your best work.

• Supervise daily activities of QA specialists across multiple operational areas • Ensure consistent execution of QA audits, scorecards, and monitoring processes • Review completed audits for accuracy and consistency • Conduct calibration sessions to ensure scoring alignment • Provide coaching, feedback, and performance management • Monitor QA productivity and turnaround times • Identify trends and support corrective actions • Ensure compliance with HIPAA, CMS, and internal policies • Escalation management and issue resolution • Support for training initiatives and documentation maintenance • KPI monitoring and operational reporting support • Partnership with operational leadership teams across departments

• Lead and grow the AI/ML Engineering team, while coordinating execution across contributors including data scientists on collaborative projects. • Design, deliver and operate the core AI/ML platform: agent frameworks, evaluation harnesses, labeling systems, document processing systems, semantic search, knowledge bases, model hosting, and more. • Run AI/ML systems at scale in production with reliability, observability, performance, and incident response. Build a culture of operational excellence. • Create processes to ensure proof-of-concept code from Data Science can be designed as production-grade services. • Partner with the Chief AI Officer and Product Manager to build forward-looking product strategy. Drive structured thinking in ambiguity. • Run tight, streamlined stand-ups across engineering and data science. Do capacity planning for driving predictability and velocity around delivery. • Provide leadership in ensuring the cross-functional team can utilize AI technologies to accelerate team excellence in coding, PR reviews, testing, observability and incident response. Keep up with the latest developments in LLM/agent advances and modern AI/ML infrastructure.

• Ensure the Machinify team delivers value to our clients through efficient operational processes, enhanced reporting, comprehensive user training, and exceptional support strategies • Help create and drive execution on client strategy including intentional relationship building and supporting growth expansion initiatives • Identify actionable insights from healthcare claims data and results • Project financial results and company revenue based on KPI data and business dynamics • Review all client-facing reporting for accuracy, including reports on: • Impacts of policy customizations or modifications • Comparing actual results to expected or projected results • Trends by product, line of business, policy, providers, etc. • Develop a deep understanding of the assigned client’s organizational structure, business objectives, and areas of opportunity and translate that understanding into a unique value proposition that Machinify can deliver measurable results against • Generate materials and reporting that can be leveraged to deliver insights to the customer and demonstrate how the program is performing against key success metrics • Document and create organizational visibility to key internal stakeholders on: • Insights including outstanding roadmap opportunities, areas of risk, and key client activities and expectations • Progress of weekly/monthly/quarterly initiatives • Key account metrics (e.g., relationship status, progress to goals, roadmap, etc.) • Work with leadership to communicate and message actionable findings to support client understanding of the data • Become an expert on company platform(s) to support client workflow, delivery, and user onboarding and training • Introduce new functionality, solutions, or capabilities and receive product feedback for formal communication internally to our Product team • Support client contracting efforts and SLA management • Monitor solution performance and deliver quantifiable and qualitative insights to customers via regular meetings, quarterly business reviews, etc. • Act as a key contact for client inquiries, client support, and all key client deliverables • Occasional travel requirements up to 25% of the year to meet client needs

Role Description A Payment Integrity Validation Specialist is an integral part of a dynamic team, aiding in the facilitation of coordination of benefits. Validation Specialists utilize access to insurance eligibility and claims payment information as well as outreach to insurance carriers to ensure member records are accurate. This role builds a foundation of knowledge that supports future advancement. What you’ll do - Verifies medical insurance eligibility data. - Accurately documents data gathered. - Meets daily production quotas. - Follows specific timeframes to complete tasks. - Uses multiple computer systems to work efficiently. - Provides excellent customer service. Qualifications - High School diploma, GED, or equivalent combination of education. - Experience with health insurance is preferred, but not required. - Excellent oral and written communication skills, including on the phone, are required. - Ability to work well independently or in a team environment. - Very strong attention to detail and organizational skills. - Word and Excel proficiency required. - Experience in the healthcare field is helpful, but not required. Requirements 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. Benefits - 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. Pay range $23.00/hour. This is a non-exempt position. 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.

• Provide software development project management + cross-functional coordination and communication to deliver outstanding products. • Manage and track engineering project delivery schedules and ensure they align with cross-functional upstream and downstream dependencies (Data Science, Data Engineering, DevOps, PM, etc) and correlate to end-to-end delivery commitments. • Identify gaps and clearly communicate them to project stakeholders, follow-through until resolution. • Take responsibility for release schedules and milestones, keeping up a high velocity in a fast-paced environment. • Drive effective and consistent processes in engineering organization, working with engineering leadership.

• Design agent systems from first principles. Decide the loop, the tools, the context strategy, the evaluation harness. Choose between single-agent and multi-agent topologies, between LLM reasoning and deterministic post-passes, between retrieval and direct context loading — and defend the choice with data. • Engineer the context. The hardest part of building a good agent is what goes into the prompt and what comes out. You'll obsess over context windows, tool surfaces, structured outputs, citation grounding, and the prompt itself. • Drive evaluation rigor. Build evals before you build the agent. Diagnose where it fails, fix the root cause, and prove the fix moved the metric. • Use AI tooling like a power user. A meaningful fraction of your day will be spent driving Claude Code, Codex, and similar tools to plan, scaffold, refactor, and debug your own work. We expect you to be faster with these tools than most engineers are without them. • Become a domain expert. Healthcare claims, coding guidelines, and the medical record itself are unavoidable parts of the job. Strong engineers who lean into the domain become outsized contributors here.

• Answer inbound ACD call line and provide prompt, professional customer service to members and insurance companies. • Create new claim files with accurate and complete information. • Regularly accesses client systems to gather information used to create inventory. • Uses multiple computer systems to review claim data and work efficiently. • Will be available to 9a - 6p, 10a -7p and 11am - 8pm EST times.

• Review and audit the work of new and existing DRG Reviewers to ensure accuracy, compliance, and alignment with established coding and clinical validation guidelines. • Provide constructive, detailed feedback to DRG Reviewers, highlighting areas for improvement and recognizing high-performance results • Collaborate with management to promote continuous improvement in audit accuracy, workflow efficiency, and reviewer performance • Assist the educator by conducting supplemental training sessions for new hires on DRG methodologies, clinical validation, and proprietary tools • Provide ongoing training to existing staff, focusing on policy updates, skill development, and performance enhancement • Maintain comprehensive documentation of audit findings, feedback sessions, and training activities • Generate reports on the quality assurance results and the effectiveness of training sessions for review by management • Work closely with team leaders and the educator to ensure the training and QA processes align with the company’s standards and objectives • Serve as an expert resource for DRG Reviewers and other staff members, answering questions and offering guidance on complex cases or procedures

• Responsible for overall management and service delivery of assigned customers and projects, including customer satisfaction and financial results. • Manage full range of project life cycle (Initiate, Plan, Execute, Close). • Build relational network within assigned accounts • Leads cross functional client-related projects across various departments • May mentor and train other Client Success Managers and team members • Leverage relational network within assigned accounts to identify opportunities to expand Performant’s services footprint • Partner with sales executives to scope opportunity and develop sales discussions with the clients • Supports building definition of offerings for potential accounts as well as assigned account base • Shared responsibility for account financial targets • Monitors forecasting and growth plans for assigned accounts • Identifies opportunities for increased efficiencies to processes, systems and tools used in delivering client services • Understands customer needs and appropriately manages customer expectations • Handles escalated problem solving and issue resolution • Has accountability for resolution of complex or escalated billing issues • Monitor overall account health and client satisfaction • Direct and supervise work of one or more Client Success Managers and/or Delivery Specialists • Sets clear expectations aligned with company and account strategy.