Machinify Logo

Machinify

Claims Administrator

Posted 21 Days Ago
Remote
Hiring Remotely in United States
24-24 Hourly
Entry level
Remote
Hiring Remotely in United States
24-24 Hourly
Entry level
As a Claims Administrator, you will support claims processing, ensure data accuracy, handle incoming claim reviews, and facilitate claims routing, while collaborating with internal teams.
The summary above was generated by AI

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.

About the Opportunity 


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 Complex Payment Solutions Team, you will, as a Claims Administrator, be responsible for supporting efficient claims processing and ensuring data accuracy throughout the review and auditing process. This role involves performing incoming claim reviews, organizing data, assigning statuses, and routing completed files to auditors while maintaining document hygiene and adhering to internal procedures.

The position requires close collaboration with internal teams to manage import queues, reconcile balances, validate charges, identify, and address errors, and facilitate claims routing. The Claims Administrator I oversee the intake and output of files, responding to inquiries, resolving discrepancies, and ensuring effective communication regarding claims.

Additionally, this role includes analyzing data trends, monitoring file-sharing processes, verifying data transfer accuracy, and ensuring appropriate volume levels are maintained. Data entry of documents and other administrative tasks are also integral to the position.

The ideal candidate demonstrates strong organizational skills, attention to detail, and the ability to work collaboratively in a dynamic environment.


What you’ll do 

  • Review incoming claims, assign statuses, organize data, and route files to auditors.
  • Collaborate with teams to manage the import queue, reconcile balances, validate charges, correct errors, and route files.
  • Oversee file intake and output, addressing inquiries, discrepancies, and errors.
  • Analyze data trends and communicate updates on claims routing, efficiency, inventory, and volume.
  • Monitor file-sharing processes, ensure data transfer accuracy, and maintain appropriate volume levels.
  • Perform data entry and support additional administrative tasks as needed.

What experience you bring (Role Requirements) 

  • Preferred experience in medical record review and knowledge of medical terminology.
  • Proficient in Microsoft Office Suite, Adobe Acrobat, and multi-monitor setups; adaptable to company-specific software.
  • Strong attention to detail, organizational, analytical, and critical thinking skills.
  • Excellent interpersonal and teamwork abilities, capable of collaborating across functions and driving change.

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: $24.00 USD per hour. This is a non-exempt position. 


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/

Similar Jobs

54 Minutes Ago
Easy Apply
Remote or Hybrid
Easy Apply
105K-150K Annually
Senior level
105K-150K Annually
Senior level
Cloud • Information Technology • Security • Software • Cybersecurity
This role involves managing LMSs, providing technical support, analyzing data, developing documentation, and supporting events, with a focus on operational excellence.
Top Skills: CornerstoneGoogle SheetsSalesforceSkilljar
55 Minutes Ago
Easy Apply
Remote or Hybrid
Easy Apply
123K-175K Annually
Senior level
123K-175K Annually
Senior level
Cloud • Information Technology • Security • Software • Cybersecurity
The Senior Program Manager will drive partner-led services execution, improve opportunity progression, and develop playbooks for scalable partner services operations.
Top Skills: CRMPartner PortalsPrmPsaServices Tracking
55 Minutes Ago
Easy Apply
Remote or Hybrid
Easy Apply
140K-200K Annually
Senior level
140K-200K Annually
Senior level
Cloud • Information Technology • Security • Software • Cybersecurity
Responsible for managing operations within classified environments, overseeing cloud infrastructure, automating tasks, and ensuring system stability in a high-security setting.
Top Skills: AnsibleAws EcsKubernetesLinuxPythonTerraform

What you need to know about the Colorado Tech Scene

With a business-friendly climate and research universities like CU Boulder and Colorado State, Colorado has made a name for itself as a startup ecosystem. The state boasts a skilled workforce and high quality of life thanks to its affordable housing, vibrant cultural scene and unparalleled opportunities for outdoor recreation. Colorado is also home to the National Renewable Energy Laboratory, helping cement its status as a hub for renewable energy innovation.

Key Facts About Colorado Tech

  • Number of Tech Workers: 260,000; 8.5% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Lockheed Martin, Century Link, Comcast, BAE Systems, Level 3
  • Key Industries: Software, artificial intelligence, aerospace, e-commerce, fintech, healthtech
  • Funding Landscape: $4.9 billion in VC funding in 2024 (Pitchbook)
  • Notable Investors: Access Venture Partners, Ridgeline Ventures, Techstars, Blackhorn Ventures
  • Research Centers and Universities: Colorado School of Mines, University of Colorado Boulder, University of Denver, Colorado State University, Mesa Laboratory, Space Science Institute, National Center for Atmospheric Research, National Renewable Energy Laboratory, Gottlieb Institute

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account