Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs. At Machinify, we’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize our clients’ financial outcomes today and drive down healthcare costs tomorrow. As part of the COB team, you will provide critical support to the Medical Claims Overpayment Identification Program while also assisting with coordination of benefits (COB) functions and healthcare claims workflows. This role ensures accurate claims research, documentation, communication, and resolution across all retraction clients and provider partners. What you’ll do - Track and manage weekly Excel reports received through a secure reporting portal, including response files and detailed status updates for members and claims. - Maintain accurate and organized supporting documentation for all investigations. - Prepare and compile supporting documentation for fee invoices. - Review potential claim overpayments and ensure identified overpayments are processed accurately and within required timeframes, consistent with industry standards for overpayment recovery roles. - Generate overpayment recovery communications as needed and clearly document reasons for retractions, reflecting best practices in claims recovery operations. - Respond to provider inquiries regarding claim status, overpayment determinations, or refunds via phone or written communication. - Gather and maintain COB data, including researching payer status, determining insurance coverage, and updating records to ensure accurate claims processing. - Verify patient eligibility, coverage details, and benefit sequencing to ensure correct primary/secondary payer alignment. - Investigate and resolve discrepancies related to COB information or claim denials. - Collaborate with internal teams to address configuration issues, eligibility discrepancies, and other factors impacting coordination of benefits. - Maintain up‑to‑date knowledge of insurance policies, Medicare/Medicaid rules, and COB regulations. - Assist in researching provider questions, appeals, and documentation requests. - Communicate directly with clients to address questions, ensure alignment, and deliver program updates. - Distribute daily workloads to Retraction Processors to support timely claim resolution. - Prepare and maintain internal reports supporting operational oversight and performance tracking. What experience you bring (Role Requirements) - Medical claims processing or claims review experience, including familiarity with claim codes, benefit coordination, and insurance plan structures. - Strong attention to detail and accuracy. - Ability to work with minimal supervision. - Proficiency in Microsoft Excel and Word. - Ability to research and interpret benefits, eligibility rules, and payer guidelines aligning with modern COB and claims coordinator expectations. - 2–4 years of experience in claims processing, customer service, claims coordination, reimbursement, payment integrity, or related healthcare roles; or an equivalent combination of education and experience. - Experience in claims overpayment, appeals processing, or COB preferred. What Success Looks Like… After 3 months - You will have a strong understanding of the role. - You begin building relationships and collaborating with peers. - You develop effective time and priorities management. - You receive initial feedback about your performance and are using it to improve. - You’ve gained confidence in your abilities and are starting to feel more comfortable in your role. After 1 year - You have mastered the tasks and responsibilities of the position, executing them with confidence and efficiency. - You have established a strong network of internal relationships and are recognized as a key collaborator. - You’ve been entrusted with greater responsibility indicating the company’s confidence in your abilities. - You see opportunities for career progression and personal development. Pay range: $55,000 - $60,000. This is an exempt position. Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee’s geographic location. What’s in it for you - PTO, Paid Holidays, and Volunteer Days - Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts - Tuition Reimbursement - Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave. - Remote and hybrid work options What values we’ll share with you - Ask why - Think big - Be humble - Optimize for customer impact - Deliver results Equal Employment Opportunity at Machinify We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

Role Description Reports directly to the Revenue Cycle Manager and is responsible for ensuring all patient visits are entered into the Practice Management System with appropriate and accurate ICD-10 and CPT codes. The charge capture specialist will be the immediate liaison for documentation improvement and optimization for revenue and compliance purposes. They will also have interactions with providers and their medical office staff within the MSO. Other responsibilities include: - Ensures accurate billing of services provided by OLS providers, including assigning the correct ICD-10 and CPT codes, modifier usage, and knowledge of NCCI edits. - Review documentation thoroughly in order to maintain high-quality results for submission of clean claims. - Reviews pending missing billing slips and ensures appropriate follow-up as necessary for timely billing. - Review DME reports daily to ensure appropriate billing. Correspond and coordinate with medical staff to escalate any issues. - Able to maintain quantity and quality goals for metrics in place. - Attends regular staff meetings, as requested. - Promote and adhere to OrthoLoneStar’s mission, core values, and vision. - Maintain satisfactory attendance in accordance with policy. - Other duties as assigned. Qualifications - High School Diploma or equivalent work-related history. - College education or trade school preferred. - Certified Professional Coder, Certified Coding Specialist, or Certified Medical Coder preferred. - Experience with Physical Therapy or Orthopedic coding preferred. - Minimum 1 year experience working in a physician group practice billing department preferred. - No licensure required. Requirements - Extensive knowledge of CPT, ICD-10 and HCPCS coding conventions. - Appropriate knowledge of CMS guidelines and ability to apply them accurately. - Extensive knowledge of anatomy, physiology, and medical terminology. - Knowledge of third-party payer reimbursement guidelines. - Strong written and verbal communication skills. - Computer literate, with keyboard skills and operational knowledge preferred. - Ability to maintain the confidentiality of sensitive information according to HIPAA. - Skill in establishing and maintaining effective working relationships with other employees, patients, and organizations. - Close attention to detail and ability to work in a fast-paced environment, which may include pressure generated by deadlines and peak workload periods. Working Conditions and Requirements - High quality and reliable internet to perform remote duties efficiently. - Remote, work-from-home setting with a 40-hour work week, Monday through Friday. Overtime is available, if necessary. - Equipment is provided but must be placed in a secluded environment. - Adequate childcare during work hours. Physical Demands - Requires manual dexterity to operate a keyboard, calculator, and other office equipment. - Near-visual acuity with color perception in order to view computer screens and decipher fine print. - Auditory acuity for hearing telephone conversations or team meetings. - Frequent sitting and use of standard office equipment. - Ability to lift 15 pounds of office supplies or equipment, if necessary.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Supervisor of Patient Responsible is responsible for motivating and leading a team of patient responsible representatives. The Supervisor of Patient Responsible delivers coaching focused on skills development and reinforcement of behaviors to achieve individual, team and organizational goals. Identifies opportunities to improve work processes, policies and procedures that enhance the patient and external stakeholder experience. - Oversee the daily activities of the team in the assigned specialty and ensure adherence to schedule, metrics and policy. - Monitor team calls and scheduling accuracies, collaborating with QA Supervisor, and documenting feedback and coaching. - Conduct monthly 1:1/coaching sessions with each team member. - Coordinate with team lead to ensure daily/weekly updates are communicated to the team. - Manage payroll and time off process for team. - Act as resource for the team and operations to resolve complex issues and questions. - Assess employee needs ensuring employees are properly trained and adhere to company policies, practices and procedures. - Handle patient escalations as necessary in a professional and empathetic manner. - Contribute ideas to improve work processes, policies and procedures that enhance the patient experience. - Conduct interviews and screens for eligible candidates for patient responsible team. - Exemplifies the desired culture and philosophies of the organization. Qualifications - High School diploma or GED minimum education requirement - One (1) year minimum requirement of supervisory experience in healthcare billing - Computer software applications including, but not limited to, MS Office and EMR system(s) - Reliable high-speed internet access and Wi-Fi connection required Requirements - Salary Range: $50,000.00/yr - $70,000.00/yr Benefits - Competitive pay - Comprehensive health and dental benefits - Tuition reimbursement - Paid time off - Retirement savings plans COVID-19 Policy As a condition of employment at Rothman Orthopaedics, it is required you receive the COVID-19 vaccination. Rothman Orthopaedics is an Equal Opportunity Employer and requests for reasonable accommodations will be considered.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Reports directly to the Revenue Cycle Manager and is responsible for ensuring all patient visits are entered into the Practice Management System with appropriate and accurate ICD-10 and CPT codes. The charge capture specialist will be the immediate liaison for documentation improvement and optimization for revenue and compliance purposes. They will also have interactions with providers and their medical office staff within the MSO. - Ensures accurate billing of services provided by OLS providers, including assigning the correct ICD-10 and CPT codes, modifier usage, and knowledge of NCCI edits. - Review documentation thoroughly in order to maintain high-quality results for submission of clean claims. - Reviews pending missing billing slips and ensures appropriate follow-up as necessary for timely billing. - Review DME reports daily to ensure appropriate billing. Correspond and coordinate with medical staff to escalate any issues. - Able to maintain quantity and quality goals for metrics in place. - Attends regular staff meetings, as requested. - Promote and adhere to OrthoLoneStar’s mission, core values, and vision. - Maintain satisfactory attendance in accordance with policy. - Other duties as assigned. Qualifications - High School Diploma or equivalent work-related history. - College education or trade school preferred. - Certified Professional Coder, Certified Coding Specialist, or Certified Medical Coder preferred. - Experience with Physical Therapy or Orthopedic coding preferred. - Minimum 1 years’ experience working in a physician group practice billing department preferred. Requirements - Extensive knowledge of CPT, ICD-10 and HCPCS coding conventions. - Appropriate knowledge of CMS guidelines and ability to apply them accurately. - Extensive knowledge of anatomy, physiology, and medical terminology. - Knowledge of third-party payer reimbursement guidelines. - Strong written and verbal communication skills. - Computer literate, with keyboard skills and operational knowledge preferred. - Ability to maintain the confidentiality of sensitive information according to HIPAA. - Skill in establishing and maintaining effective working relationships with other employees, patients, and organizations. - Close attention to detail and ability to work in a fast-paced environment, which may include pressure generated by deadlines and peak workload periods. Working Conditions and Requirements - High quality and reliable internet to perform remote duties efficiently. - Remote, work-from-home setting with a 40-hour work week, Monday through Friday. Overtime is available, if necessary. - Equipment is provided but must be placed in a secluded environment. - Adequate childcare during work hours. Physical Demands - Requires manual dexterity to operate a keyboard, calculator, and other office equipment. - Near-visual acuity with color perception in order to view computer screens and decipher fine print. - Auditory acuity for hearing telephone conversations or team meetings. - Frequent sitting and use of standard office equipment. - Ability to lift 15 pounds of office supplies or equipment, if necessary.