Teams at Machinify

Review facility claims and medical records to determine billing, coding, and clinical appropriateness per client policy and industry guidelines. Research policies, identify experimental/Do Not Bill/HAC charges, analyze medications and itemized bills, develop review content and references, support client initiatives and appeals, train staff, and meet productivity and accuracy targets.

Investigate health insurance claims to identify recoverable losses from third parties, document findings in systems, negotiate with members/adjusters/attorneys, review contracts, prepare expense spreadsheets, and process recovery payments.

As a Nurse Itemized Bill Reviewer, you'll assess facility insurance claims for accuracy, ensuring compliance with client policies and industry standards, and enhancing claim processing efficiency.