Title: Dispute Resolution Analyst I Location: United States Full Time Entry Level Remote Job Description: Position: Dispute Resolution Analyst Overview: J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since company inception in 2017 as a healthcare management consulting company. Our team of 260 employees focuses on providing processing, review, and analysis of medical claims, records, data, and audits between areas of compliance, policy, and clinical expertise. Our team is experienced in program, payment, provider, and patient integrity as we continue to support advanced programs of policy, clinical requirements, and compliance measures at the commercial, State, and Federal levels. J29 was founded to be an employee-centric company that prioritizes the well-being and value of its employees. Our mission is to empower our employees to do great things for the benefit of those that need it most. The J29 mission supports not only our health and human service programs, but also the philanthropy efforts of our team. We are proud to continue our support to non-profit groups with critical missions as J29 continues to grow. Position: As a Dispute Resolution Analyst (DRA) you’ll support the Independent Dispute Resolution (IDR) programs that handle routine 'Surprise Billing' appeals work. This role will serve as a support person for the reconsideration/dispute resolution professionals and physician reviewers for second level reconsiderations/dispute resolutions. Additionally, the DRA position will work under close supervision, with minimal latitude for the use of initiative and independent judgement Role & Responsibilities: - Coordinates the delivery of re-determination files/dispute resolution documents and reconsideration/dispute resolution decisions from and to the external entities. - Builds a reconsideration/dispute resolution case file from evidence submitted and received and analyzes each case to ensure it meets the requirements for a valid reconsideration/dispute resolution request as mandated by Centers for Medicare and Medicaid Services (CMS) or other customer entities. - Analyzes and makes decisions based on medical vs. non-medical case type, appeal/review categories, validity of appeal/dispute resolution request, and dispute resolution settlement documentation. - Inputs appropriate data regarding reconsiderations/dispute resolution cases into the applicable required systems. - Responds to reconsideration/dispute review requests from appellants/patients/providers. - Routes or responds to telephonic and/or written inquiries from appellants/patients about reconsiderations/dispute resolution or about the reconsiderations/dispute resolutions process from appellants/patient or their legally-designated representatives. - Identifies any suspected instances of fraud and/or abuse and immediately inform management of such issues. - Stays abreast of changes in regulations and practices, policies and procedures - May submit requests for re-determination files and completed reconsideration and Administrative Law Judge (ALJ) decisions to relevant entities. - Participates in special projects and performs other duties as assigned. Experience / Expertise: - One (1) years of experience with Provider disputes or claims - One (1) years of interaction with claims with larger insurance plans - One (1) year of general office or administrative experience - Experience directly relevant to the specific task order or project, preferred Education: • High School Diploma or equivalent Location: Remote Salary: $16.25-18.25 per hour J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. J29, Inc. is a proud Veteran friendly employer.

Title: Senior Financial Analyst Location: Maple Grove, MN Full time Hybrid Job Description: About Bora Bora Pharmaceuticals is a premier international contract development and manufacturing organization (CDMO) specializing in formulation development, clinical and commercial manufacturing, and packaging of complex oral solid dose, liquid, semi-solid, biologics, and sterile injectable pharmaceutical products. From our world-class sites in North America and Asia, we deliver drug products with unparalleled quality to more than 100 markets around the world. Bora’s teams, technologies, and facilities work seamlessly together to enable our clients to deliver much-needed therapeutics to patients worldwide. At Bora Pharmaceuticals, we see it as our mission, our duty, our responsibility, to make our success and our customer’s success more certain. Job Summary The Senior Financial Analyst / Senior Cost Accountant is a hybrid role responsible for financial planning and analysis, detailed manufacturing cost accounting, and month-end close execution within a Contract Development and Manufacturing Organization (CDMO). This position partners closely with Operations, Supply Chain, Program Management, and Accounting to ensure accurate financial reporting, product costing, margin analysis, and operational decision support across development and commercial manufacturing programs. Essential Functions Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions. Month-End Close & Financial Reporting - Execute monthly close activities for operations in accordance with GAAP - Prepare inventory valuation, COGS calculations, and manufacturing journal entries - Perform manufacturing overhead allocation and absorption analysis - Analyze labor, material, and overhead variances and explain drivers - Prepare and post accruals and other journal entries - Reconcile inventory, WIP, and variance accounts - Support internal and external audits - Continuously improve close efficiency, controls, and documentation Cost Accounting & Manufacturing Finance - Develop and maintain standard costing models for materials, labor, overhead, and subcontracted services - Perform detailed variance analysis including PPV, labor efficiency, yield, scrap, and overhead variances - Partner with Operations and Supply Chain to drive cost transparency and improvement - Support new product introductions, technology transfers, and scale-up activities - Ensure compliance with inventory accounting policies - Financial Planning & Analysis (FP&A) - Lead budgeting and forecasting process - Develop financial models related to capacity utilization, margins, and capital investments - Analyze program- and customer-level profitability - Prepare monthly operating reviews and financial presentations for leadership - Systems, Controls & Process Improvement - Serve as finance SME for SAP ERP system - Improve costing accuracy, reporting automation, and close-cycle efficiency - Maintain documentation of costing methodologies and close procedure The above statements are intended to describe the nature of work performed by those in this job and are not an exhaustive list of all duties. Nothing in this job description restricts managements right to assign or reassign duties and responsibilities to this job at any time which reflects management’s assignment of essential functions. Minimum Education, Experience, and Skills - Bachelor’s degree in Finance, Accounting, or related field - 3-5 years of experience in manufacturing finance, cost accounting, and month-end close - Strong understanding of standard costing, variance analysis, and inventory accounting - Advanced Excel and financial modeling skills - Experience partnering with Operations and Supply Chain teams Compensation Range: 108,000 - 140,000 Compensation and Benefits We offer a comprehensive benefits package designed to support our employees’ wellbeing, including: - Competitive salary and performance-based incentives - Comprehensive health coverage including medical, dental, and vision insurance - Retirement savings plans with employer matching contributions - Paid time off - Professional development opportunities - Employee wellness programs and resources - Employee Assistance Program and Mental Health Resources Core Values At Bora, our values guide everything we do — from how we solve challenges to how we support our people. We lead with a solutions-first mindset, strive to do the right thing, stay proactive, and above all, respect everyone. Bora Pharmaceuticals is committed to providing equal employment opportunity to all applicants and employees according to all applicable equal opportunity and affirmative action laws, directives and regulations of federal, state and local governing bodies and agencies. In keeping with this commitment, Bora Pharmaceuticals will recruit, hire, train and promote persons in all job titles, without regard to race, color, creed, religion, sex (including factors related to pregnancy or child birth), national origin, age, marital status, familial status, disability, sexual orientation, gender identity status with regard to public assistance, employment status, local human rights commission activity, status as a protected veteran, genetic information, atypical hereditary cellular or blood trait, or any other protected category.

Prepare and analyze medical claims for accuracy and completeness, expedite adjudication processes, resolve payment issues, and establish effective relationships with stakeholders to ensure prompt payment and proper claim handling.

Title: Senior Content Analyst (Claims editing) Location: US 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. We’re seeking a skilled Senior Content Analyst to join our Claims Editing team! As a Sr. Content Analyst on the Payment Integrity – Policy & Content Management team, you will interpret healthcare reimbursement policies and translate them into precise, automated claims editing logic that drives payment accuracy. This is a deep subject-matter-expert role focused on applying regulatory guidance, coding standards, and payer rules to create deterministic, testable edits that identify incorrect coding, billing, and reimbursement. You’ll own edit concepts end-to-end, from interpretation through validation and ongoing refinement, with opportunities to contribute to the evolution of content approaches over time. This role offers high autonomy and ownership for someone who understands how claims should be paid and thrives on turning complex rules into clear, enforceable logic. What You’ll Do: Policy Interpretation & Edit Development - Interpret and apply CMS, Medicare, Medicaid, AMA/CPT, NCCI, and other payer policies to define accurate claims editing logic. - Translate regulatory and coding guidance into clear, deterministic pre-pay edits, with documented rationale and references. - Build and maintain a proprietary library of claims edits aligned to reimbursement rules and industry standards. - Identify reimbursement risk areas and policy interpretation gaps and encode them into actionable edit concepts. Claims Validation & Analysis - Own the development of high-quality edit specifications, including logic definitions, assumptions, edge cases, and validation criteria. - Analyze claims and edit performance data to confirm accuracy, reduce false positives, and prioritize enhancements by impact. - Conduct targeted manual claim reviews to validate coding accuracy, reimbursement correctness, and policy alignment. Cross-Functional Enablement - Serve as a SME across Medicare, Medicaid, and commercial claims. - Partner with product, engineering, and implementation teams to ensure edits are implemented and validated correctly. - Clearly document edit logic, policy interpretation, and outcomes to support internal teams and payer stakeholders. Governance & Ongoing Maintenance - Proactively monitor regulatory updates, coding changes, and industry guidance to keep edits current and compliant. - Ensure all edits are auditable, defensible, and aligned with external policy sources. - Consistently meet productivity and quality expectations in a remote, outcomes-driven environment. What You Bring: - 4+ years of experience in authoring claims editing content with either vendors or payers - Deep expertise in: - CMS policies (LCDs, NCDs, fee schedules) - NCCI (PTP and MUE) edits, OIG guidance, correct coding methodologies - CPT/HCPCS, ICD-10-CM/PCS, modifiers, place of service, and revenue codes - Strong understanding of claims processing workflows (CMS-1500, UB-04). Extra points if you bring: - SQL skills for claims analysis or edit opportunity identification. - Clinical background (RN, BSN, PharmD, MD, or equivalent). What We Offer: - Work from anywhere in the US! Machinify is digital-first. - Top Medical/Dental/Vision offerings - FSA/HSA - Solid PTO program - Tuition reimbursement - Competitive salary, 401(k) with company match - Additional health and wellness benefits and perks - Flexible and trusting environment where you’ll feel empowered to do your best work The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. 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