Performant Corp

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range: $23.00 As a Healthcare Billing Recovery Analyst, you will be assigned a Provider portfolio and be tasked with managing it from a Recovery standpoint. In this role you will have the opportunity to leverage your well-versed background in Coordination of Benefits as well as Medicare/Medicaid and procedural challenges/regulations, and experience in generating outbound communications to Providers, with proven ability to gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues. Key Responsibilities - Engage in Outbound recovery calls, to Healthcare Carriers and Providers regarding improperly paid claims - Decision Support- Ability to accurately review supporting documentation provided to Performant, by Providers/Carriers to determine accuracy of finding or overpayment allegation, for Complex appeals and disputes. - Maintain current knowledge in Medicare and Medicaid practices and regulatory issues that may affect our clients. - Leverage your knowledge and expertise to research Overpayments and answer questions and/or provide information that will bring to successful resolution and payment. - Educate Healthcare providers/carriers on their obligation to pay. - Ability to analyze and understand written communication from insurance companies including explanation of benefits. - Support internal groups or functions with gathering and interpretation of the billing and collections work to development with knowledge base and understanding of key concepts and terminology in healthcare billing and claims. - Leverages existing excel skills to create Provider centric reporting on demand, or at Managements request. - Effectively follow and contribute to continuous improvement of scripts, guidelines and other tools provided to have professional conversations with Healthcare Insurance providers - Efficiently and diligently work through assigned inventories to meet productivity metrics assigned by management - Ability to maintain and function in multiple client systems and environments at one time. - Updates company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, payment commitments, as well as account status updates as applicable. - Updates company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, payment commitments, as well as account status updates as applicable. - Arrives to work on-time, works assigned schedule, and maintains regular attendance - Follows and complies with company and departmental policies, processes and procedures - Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations - Successfully completes, retains, applies and adheres to content in required training as assigned. - Consistently achieve or exceed established metrics and goals assigned - Demonstrates Performant core values in performance of job duties and all interactions - Correct areas of deficiency and oversight received from quality reviews and/or management. Knowledge, Skills and Abilities Needed - Ability to demonstrate, strong written and verbal communication skills - Basic understanding of revenue cycle management or Medical recovery. - Strong knowledge and material experience with Healthcare, Medical terminology, Coding, Billing. Preferably a role in recovery or revenue cycle management. - Demonstrates knowledge in post-payment recovery. - Demonstrates the ability to solve complex Provider or Carrier billing questions, that assist in the resolution and understanding of the overpayment. - Communicates effectively with Providers and Carriers to answer any questions and/or provide information that will bring successful payment or other resolution to the account. - Demonstrated expertise in Medicare and Medicaid plans policy and procedure - Up to date knowledge in Medicare/Medicaid appeal processing - Knowledge in Coordination or benefits (COB) - Demonstrates a high degree of critical thinking and analytical accuracy required to be successful. - Proven ability to gather and interpret explanation of benefits (EOB) and answer questions and resolve standard as well as complex issues with payments. - Strong skills using standard office technology; Computer, various applications and navigation of on-line tools and resources. - Intermediary to Advanced excel skills. - Applies knowledge learned in training - Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail. - Must have the availability to communicate via phone with Providers and or Carriers in a quiet space 5+ hours daily. Required and Preferred Qualifications - Bachelor’s degree in relevant field or equivalent combination of education and experience. Significant experience along with a high school diploma, may also be considered in lieu of a completed degree. - At least 3 years directly relevant professional working experience in a highly analytic or Recovery role. - Experience in Healthcare Billing and/or Coding is required - Knowledge or experience with Healthcare, Coordination of benefits or Revenue cycle management, and the like. - Other requirements may apply WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Expected Hiring Range: $84,000 - $100,000 (based on experience) The Medical Review Nurse II - SNF/MDS primarily performs medical claims audit reviews. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government and Commercial Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team. Key Responsibilities: - Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules. - Document all findings referencing the appropriate policies and rules. - Generate letters articulating audit findings. - Supporting your findings during the appeals process if requested. - Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse. - Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits. - Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients. - Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members. - Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines. - Interface with and support the Medical Director and cross train in all clinical departments/areas. - Other duties as required to meet business needs. Knowledge, Skills and Abilities Needed: - Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual. - Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding. - Knowledge of insurance programs program, particularly the coverage and payment rules. - Ability to maintain high quality work while meeting strict deadlines. - Excellent written and verbal communication skills. - Ability to manage multiple tasks including desk audits and claims review. - Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings. - Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload - Effectively work independently and as a team, in a remote setting. Required and Preferred Qualifications: - Active unrestricted RN license in good standing, is required. - Must not be currently sanctioned or excluded from the Medicare program by the OIG. - Minimum of five (5) years diversified nursing experience providing direct care in an inpatient or outpatient setting. - One (1) or more years' experience performing medical records review. - One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required. - Strong preference for experience performing utilization review for an insurance company, Tricare, MAC, or organizations performing similar functions. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Expected Hiring Range: $72-78k, may be adjusted to reflect applicant experience The Medical Review Nurse II - Readmissions primarily performs medical claims audit reviews. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government and Commercial Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team. Key Responsibilities: - Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules. - Document all findings referencing the appropriate policies and rules. - Generate letters articulating audit findings. - Supporting your findings during the appeals process if requested. - Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse. - Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits. - Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients. - Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members. - Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines. - Interface with and support the Medical Director and cross train in all clinical departments/areas. - Other duties as required to meet business needs. Knowledge, Skills and Abilities Needed: - Knowledge of insurance programs, particularly the coverage and payment rules. - Ability to maintain high quality work while meeting strict deadlines. - Excellent written and verbal communication skills. - Ability to manage multiple tasks including desk audits and claims review. - Must be able to independently use standard office computer technology. - Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload - Effectively work independently and as a team, in a remote setting. Required and Preferred Qualifications: - Active unrestricted RN license in good standing, is required. - Must not be currently sanctioned or excluded from the Medicare program by the OIG. - Minimum of five (5) years diversified nursing experience providing direct care in an inpatient setting. - One (1) or more years' experience performing medical records review. - One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required. - Other qualifications may be required and would be discussed during an interview. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range: $19 - $20 As a Healthcare Billing Recovery Case Specialist I (SCA), you will work Group Healthcare (GHP) and/or Non-Group Healthcare (NGHP) Provider delinquent accounts under the CMS Medicare Secondary Payer recovery program. The medical billing specialist in this role will come with strong knowledge of medical claim billing, medical terminology and medical coding, forms UB04 and CMS 1500, Coordination of Benefits and Third Party Liability (COB/TPL), Medicare Secondary Payer (MSP) claims, and procedural challenges regulations; experience generating or auditing medical claims and billing; proven ability to gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues; and communicate effectively with carriers to recapture payments. Key Responsibilities - Review account claim and other documentation to verify payment liability for claims that may have been paid by Medicare in error. - Leverage your knowledge and expertise in medical billing/COB/MSP to review documentation and claim billing, build the case file to determine/validate liability, evaluate and respond to defenses refuting payment liability, status the account and initiate appropriate letter correspondence, answer questions and/or provide information that will bring to successful payment or other appropriate account action. - Initiate correct action with applicable party (health insurance carrier, auto/home/worker’s comp insurance carrier, or legal representative) and documentation based upon payment option, actions required if new information is identified that may change the obligation to pay, or escalation in the event of refusal to pay. - Updates client and/or company systems with clear and accurate information such as contact and updated demographic information, notes from contact dialog and attempts, payment commitment, as well as account status updates as applicable. - Initiates applicable claim activities; follows-up and follows through accordingly to ensure documentation and activity is on-time and accurate in accordance with policies and procedures. - Support internal groups or functions with interpretation of EOB (explanation of benefits), as well as development of knowledge base and understanding of key concepts and terminology in healthcare billing and claims. - Arrives to work on-time, works assigned schedule, and maintains regular good attendance. - Follows and complies with company, departmental and client program policies, processes and procedures. - Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations. - Successfully completes, retains, applies and adheres to content in required training as assigned - Consistently achieve or exceed established metrics and goals assigned, including but not limited to, production and quality. - Completes required processes to obtain client required clearances as well as company regular background and/or drug screening; and, successfully passes and/or obtains and maintains clearances statuses as a condition of employment. (note: client/government clearance requirements are not determined or decisioned by Performant.) - Demonstrates Performant core values in performance of job duties and all interactions. - Correct areas of deficiency and oversight received from quality reviews and/or management. - Work overtime as may be required. - May be required to work some Performant holidays due to client requirement. - Performs other duties as assigned. Knowledge, Skills and Abilities Needed - Knowledge and experience with medical claim billing procedures, medical terminology and medical coding, preferably in a role generating, auditing, recovery and/or researching the same. - Familiarity with information in forms UB04 and CMS 1500 - Experience with Coordination of Benefits, Third Party Liability, Medicare Secondary Payer - Proven ability to gather and interpret Explanation of Benefits (EOB) to answer questions and resolve medical billing issues; - Ability to communicate professionally and effectively with providers, carriers, beneficiaries and other audiences regarding claims and billing payment. - Experience in handling Medicare and Medicaid claims. - Protected patients’ privacy, understands and adheres to HIPAA standards and regulations. - Remarkable interpersonal and communication skills; ability to listen, be succinct and demonstrate positive customer service attitude. - Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail. - Proficiency using standard office technology; computer, various applications and navigation of on-line tools and resources, keyboard, mouse, phone, headset. - Ability to apply knowledge learned in training from various forms (memos, classroom training, on-line training, meetings, discussions, individual coaching, etc.). - Ability to follow process, procedures and regulations in the workplace. - Ability to effectively perform work independently, and work cooperatively with others to promote a positive team environment. - Ability to adapt quickly and transition effectively to changing circumstances, assignments, programs, processes. - Ability to consistently perform job responsibilities. - Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening. - Completion of Teleworker Agreement upon hire, and adherence to the Agreement (including applicable policies and procedures), which includes, but not limited to, basic home office suitability requirements such as high-speed internet connectivity, appropriate work-space for compliance with confidentiality, HIPAA, safety and ergonomics, and work environment allowing dedicated work-focus without distraction during work hours. - Possess a personality type that is ethical, friendly, hard-working and proactive. Required and Preferred Qualifications - Minimum 6 months of medical billing experience, including Medicare, demonstrating depth of knowledge and capability required for the position. - Minimum 2 years of experience in customer service, billing reclamation or recovery, or call center role demonstrating application of similar skills. - High School diploma or GED is required. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range: $85,000 - $95,000 We are seeking a Sr. Business Operations Analyst with strong knowledge of healthcare claims, medical terminology, eligibility validation practices, Coordination of Benefits and Third-Party Liability (COB/TPL), or Medicare Secondary Payer (MSP). This position will also support new client implementations and existing programs with requirements gathering related to healthcare claims data. Key Responsibilities: - Leverage knowledge and expertise in COB/TPL/MSP to analyze claims data. - Perform detailed analysis to identify trends, patterns to improve existing processes. - With minimalize supervision conducts analysis to support business decision making - Assist technical and business leads with requirements gathering and documentation for new implementations and existing program changes. - Conducts a variety of data analysis for intelligent insights using subject matter knowledge, independent judgement, and analytical expertise. - Creates complex custom queries to meet reporting needs of internal and external stakeholders. - Working independently conducts research, analyzes trends and activities, and presents data and findings based upon business needs and as need to identify opportunities, root causes of issues and to support business decisions and strategies. - Performs QA and UAT as needed. - Collaborates with technical and business leaders to minimize risks while increasing performance. - Assists to with review of medical claims pre and post adjudication to identify business improvements and processes. - Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations. - Successfully completes, retains, applies, and adheres to content in required training as assigned. - Completes required processes to obtain client required clearances as well as company regular background and/or drug screening; and successfully passes and/or obtains and maintains. - Demonstrates Performant core values in performance of job duties and all interactions. - Correct areas of deficiency and oversight received from quality reviews and/or management. Knowledge, Skills & Abilities Needed: - Knowledge of and ability to work with large volumes of eligibility and claims data. - Working knowledge of healthcare medical and pharmacy claims, including billing requirements - Experience with Medicaid / Medicare / Other TPL business models and products - Knowledge of requirements gathering, ETL processing and data matching - Robust system skills with ability to quickly develop expertise in new systems and applications. - Advanced skills in Excel, Access, and/or other data analysis applications - Proficiency with SQL skills to query and test - Advanced knowledge of X12 EDI Transactions, including, but not limited to 270/271, 277, 837, 835. - Professional verbal and written communication with good presentation skills - Able to work independently and meet deadlines with minimal supervision. - Strong problem solving and communication (written and oral) skills. - Ability to produce results and maintain a positive attitude in fast paced, dynamic environment. - Initiative-taking and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen diligence. - Ability to develop and clearly communicate business rules to production engineers and developer. - Make sense of complex systems to understand how things work and how problems arise. - Identify areas for operational efficiency and recommend solutions for process improvements or automation. Required & Preferred Qualifications: - Bachelor’s degree in relevant field or equivalent combination of education and experience. - 7+ years relevant experience working with healthcare claims data - Experience with data modeling and analysis - Knowledge and experience with Healthcare, Coordination of Benefits, Third Party Liability, and/or Medicare Secondary Payer WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range: $85,000 - $95,000 We are seeking a detail-oriented Data Analyst to deliver accurate, timely, and insightful reporting. This role will focus on transforming complex data into clear, actionable reports that support business and client requirements. The ideal candidate has strong analytical skills, deep experience with reporting frameworks, and the ability to collaborate closely with stakeholders to translate priorities into meaningful data outputs. Key Responsibilities: - Serve as primary data and reporting analyst for new and existing clients, including but not limited to external requests. - Leverage in-house priority tools to establish and run daily, weekly, and monthly reports. - Ensure reports meet defined accuracy, timelines, and formatting standards. - Follow established report definitions, business rules, and documentation. - Assists technical and business leads with reporting requirements gathering and documentation. - Performs routine data quality checks to identify missing, inconsistent, or out-of-range values. - Analyze and reconcile multiple data sources to identify and select the most accurate record when duplicates or conflicting information exists. - Develop and maintain processes for ensuring data integrity, including deduplication and validation across large datasets. - Support internal audits and regulatory reporting requests as directed. - Help identify opportunities to improve report clarity, efficiency, or automation. - Assist with ad-hoc reporting requests from business partners. - Corrects areas of deficiency and oversight received from quality reviews and/or management. - Conducts a variety of data analysis for intelligent insights using subject matter knowledge, independent judgement, and analytical expertise. Knowledge, Skills and Abilities Needed: - Knowledge of and ability to work with large volumes of health care eligibility data - Experience with Medicaid / Medicare / Other TPL business models and products - Strong system skills with ability to quickly develop expertise in new systems and applications. - Advanced skills in Excel, Access and/or other data analysis applications - Strong knowledge of SQL - Strong experience for querying, validating, and testing. - General knowledge of X12 EDI Transactions, including, but not limited to 837s, 835s. - Professional verbal and written communication with good presentation skills. - Able to work independently and meet deadlines with minimal supervision. - Strong communication skills for presenting insights and collaborating with stakeholders. - Ability to produce results and maintain positive attitude in fast paced, dynamic environment. - Self-motivated and thrives in a fast-paced department performing multiple tasks cohesively, with keen attention to detail while ensuring accuracy and integrity. - Exceptional attention to detail, problem-solving ability, and intuition for identifying anomalies and inconsistencies in data. Required and Preferred Qualifications: - Bachelor’s degree in relevant field or equivalent combination of education and experience. - 5+ years relevant experience working with healthcare claims data. - Knowledge and experience with Healthcare, Coordination of Benefits, Third Party Liability, and/or Medicare Secondary Payer. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range: $61,300 - $73,000 The HCS Operations Inventory & Quality Analyst (Eligibility), leverages strong knowledge of healthcare eligibility, healthcare claims, eligibility validation practices, Coordination of Benefits and Third-Party Liability (COB/TPL), or Medicare Secondary Payer (MSP), plus strong data analysis and technical skills to support inventory management, process documentation, and production QA process for assigned operations teams in the Eligibility organization. Key Responsibilities - Work closely with the operations teams and data team to ensure inventory is accurately and efficiently distributed/assigned and transferred across teams based upon applicable inventory type workflow and requirements. - Conduct auditing of operations team activities on inventory to validate compliance with internal requirements, client contracts, regulatory requirements, and industry quality standards. - Facilitate communications and collaborate to convey/clarify requirements for inventory data flow based upon client/type/source serving as a liaison between the operations and eligibility & analytics data team. - Utilize SQL queries (and develop queries as may be needed) and leverage subject matter knowledge, independent judgement, and analytical skills to: - Test data transfer/flow results. - Perform audit activity. - Create and maintain regular internal/external activity and metrics reporting; and - Other support for operations workflow and activity. - Mentors operations team and data team on paper and electronic claims processes - Creates and maintains internal and external reporting as needed. - Contribute to development and continuous improvement of operational tools, processes and procedures for quality and inventory. - Provides Supervisors/Management with staff production quality results, as well as any insights for feedback/coaching/training opportunities based upon themes/trends identified to correct areas of quality deficiency and improve overall results. - May support management with developing or delivering training and tools for skills development to increase capability and effectiveness of analysts. - Operates under minimal supervision to deliver results aligned with business goals, given guidance in the form of high-level objectives. - Follows and complies with company, departmental and client program policies, processes, and procedures. - Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations. - Successfully completes, retains, applies, and adheres to content in required training as assigned. - Correct areas of deficiency and/or areas of opportunity for improvement received from management. Knowledge, Skills and Abilities Needed - Knowledge and experience with rules around Medicaid / Medicare COB Other TPL business models and products - Skilled working with operations systems, tools, and applications for collecting and reporting data as well as identifying trends. - Demonstrated ability to work with large volumes of healthcare eligibility and claims data. - Intermediate skills in MS Excel required. - Utilization of SQL to run queries. Ability to develop basic queries a plus. - Strong general system and application skills with ability to quickly develop expertise in new systems and applications. - General knowledge of 270/271, 834, 277, 837, 835 highly desired - Familiarity with JIRA a plus - Professional verbal and written communication with good presentation skills - Ability to follow, document, and teach, as well as support improvement of, processes, procedures, and workflow. - Ability to work independently with minimal supervision - Strong analytical and problem-solving skills - Skilled at gathering, researching, interpreting, and documenting data and requirements for projects and/or complex problem solving. - Ability to produce results and maintain positive attitude in a dynamic environment. - Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail. - Protects patients’ privacy, understands, and adheres to HIPAA standards and regulations. - Self-motivated and thrives in a fast-paced office environment performing multiple tasks cohesively, with keen attention to detail. - Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs. - Ability to consistently perform job responsibilities. Required and Preferred Qualifications - Bachelor’s degree in relevant field, or equivalent combination of education and experience. - At least three (3) years of directly related progressive experience (claims, billing, eligibility, Medicaid/Medicare, etc.), including Coordination of Benefits and Third-Party Liability, demonstrating depth and breadth of knowledge and capability required for the position. - Minimum two (2) years relevant experience demonstrating ability to work with large volumes of healthcare eligibility or client data, including data reporting, modeling, and analysis. - Minimum 1 year of relevant experience in role(s) with responsibility for applying subject matter expertise to operations workflow, contributing to the set-up of new clients or programs, projects, quality/auditing, direct or indirect staff oversight or training, etc. and contributing to the development of infrastructure and continuous improvement for department output. - Other requirements and qualification may apply. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Eligibility and Recovery Claims Lead will possess advanced knowledge of healthcare eligibility, healthcare claims, medical terminology, eligibility validation practices, Coordination of Benefits and Third-Party Liability (COB/TPL). This position will also support new client implementations and existing programs with detailed analysis of all claiming operations, including but not limited to outgoing and incoming healthcare EDI transactions. - Leverage knowledge and expertise in COB and TPL to review healthcare claims and client data. - Review and analyze client data to identify trends, patterns, and impacts across various products. - Assist technical and business leads with requirements gathering, documentation, and project management for new implementations and existing program changes. - Conduct a variety of data analysis for intelligent insights using subject matter knowledge, independent judgment, and analytical expertise. - Develop custom queries and reporting, conduct research, analyze trends and activities, and present data and findings based on business needs to identify opportunities and root causes of issues. - Collaborate with leadership to provide effective and detailed analysis required for optimal business operations. - Maintain a strong team through meetings, training, coaching, mentoring, and other development techniques. - Follow and comply with company, departmental, and client program policies, processes, and procedures. - Utilize resources to ensure compliance with client requirements, HIPAA, and applicable federal or state regulations. - Successfully complete, retain, apply, and adhere to content in required training as assigned. - Complete required processes to obtain client-required clearances and successfully pass background and/or drug screening as a condition of employment. - Demonstrate Performant core values in performance of job duties and all interactions. - Correct areas of deficiency and oversight received from quality reviews and/or management. - Other duties as assigned. Qualifications - Knowledge of and ability to work with large volumes of healthcare claims data. - Knowledge of healthcare medical and pharmacy claims. - Experience with Medicaid / Medicare / Other TPL business models and products. - Knowledge of requirements gathering, ETL processing, and data matching. - Strong system skills with ability to quickly develop expertise in new systems and applications. - Advanced skills in Excel, Access, and/or other data analysis applications. - Proficient SQL skills to query and test. - Advanced knowledge of X12 EDI Transactions, including but not limited to 270/271, 277, 837, 835, 834. - Professional verbal and written communication with good presentation skills. - Able to work independently and meet deadlines with minimal supervision. - Strong problem-solving and communication (written and oral) skills. - Ability to produce results and maintain a positive attitude in a fast-paced, dynamic environment. - Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail. Requirements - Bachelor’s degree in relevant field, or equivalent combination of education and experience may be considered. - 7+ years relevant experience working with healthcare claims data. - 3+ years management or supervisory experience. - Advanced knowledge and experience with healthcare claim operations, Coordination of Benefits, and Third Party Liability. Benefits - Medical, dental, vision, HSA/FSA options. - Life insurance coverage. - 401(k) savings plans. - Family/parental leave. - Paid holidays. - Paid time off annually.

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range: $20.00 - $23.00 / Hour As a Healthcare Coordination of Benefits Analyst, you will review assigned pre-pay or post-pay records, investigate coverage, and determine primacy to maximize revenue for our client’s recovery programs. Key Responsibilities - Review eligibility and other documentation to verify current payer order of benefits. - Leverage your knowledge and expertise in COB/TPL to review eligibility, investigate the policy coverage to determine proper order of benefits and answer questions and/or provide information that will bring to successful payment or other appropriate account action. - Ability to identify trends from payer data in order to isolate policy details to process appropriately per client and business needs. - Contact Healthcare Insurance carriers, employers, and/or providers regarding eligibility discrepancies. - Educate Healthcare Insurance carriers, employers, and/or providers on the Coordination of Benefits rules. - Analyze and understand written communication from insurance companies including explanation of benefits (EOBs) - Support internal groups or functions with gathering and interpretation of the eligibility work to develop knowledge base and understanding of key concepts and terminology in healthcare eligibility. - Effectively follow and contribute to continuous improvement of scripts, guidelines and other tools provided to have professional conversations with Healthcare Insurance carriers, employers, and/or providers - Efficiently and diligently work through assigned inventories to meet productivity metrics assigned by management. - Leverage your knowledge and expertise to research various scenarios that will bring successful resolution and payment (e.g., eligibility research and claims appeals) - Initiate applicable action and documentation based upon insurance carriers selected - Update company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, as well as account status updates as applicable - Arrives to work on-time, works assigned schedule, and maintains regular good attendance. - Follows and complies with company, departmental and client program policies, processes, and procedures. - Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations. - Successfully completes, retains, applies, and adheres to content in required training as assigned. - Consistently achieves or exceeds established metrics and goals assigned, including but not limited to, production and quality. - Completes required processes to obtain client required clearances as well as company regular background and/or drug screening; and successfully passes and/or obtains and maintains clearances statuses as a condition of employment. (note: client/government clearance requirements are not determined or decisioned by Performant.) - Demonstrates Performant core values in performance of job duties and all interactions. - Correct areas of deficiency and oversight received from quality reviews and/or management. - Work overtime as may be required and pre-approved by management. - Performs other duties as assigned. Knowledge, Skills and Abilities Needed - Knowledge and experience with Healthcare, medical terminology, and medical coding, preferably in a role generating, auditing, recovery and/or researching the same. - Experience with Medicaid, Coordination of Benefits and Third Party Liability. - Proven ability to gather and interpret Explanation of Benefits (EOB) to answer questions and resolve primacy issues. - Ability to communicate professionally and effectively with providers, carriers, beneficiaries and other audiences regarding eligibility and/or Coordination of Benefits (COB). - Proven ability to gather and interpret Explanation of Benefits (EOB) and answer questions and resolve issues with payment. - Proven ability to research coverage on online payer portals. - Protected patients’ privacy, understands and adheres to HIPAA standards and regulations. - Remarkable interpersonal and communication skills; ability to listen, be succinct and demonstrate positive customer service attitude. - Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail. - Proficiency using standard office technology; computer, various applications and navigation of on-line tools and resources, keyboard, mouse, phone, headset. - Ability to apply knowledge learned in training from various forms (memos, classroom training, on-line training, meetings, discussions, individual coaching, etc.). - Ability to follow process, procedures, and regulations in the workplace. - Ability to effectively perform work independently and work cooperatively with others to promote a positive team environment. - Ability to adapt quickly and transition effectively to changing circumstances, assignments, programs, processes. - Ability to consistently perform job responsibilities. - Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening. - Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours. Required and Preferred Qualifications - High School diploma or GED. Relevant college courses or certification a plus. - Minimum 2 years of directly relevant progressive experience in Healthcare with a focus including but not limited to claims, billing, membership, enrollment, eligibility, customer service and/or call center demonstrating depth of knowledge and capability required for the position. - 12 months direct experience in COB, TPL, Reclamation and/or Recovery is preferred. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. - Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. - Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). - Regularly sit/stand 8 or more hours per day. - Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: - Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. - Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. - Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. - Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify’s Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING