Healthcare Data Analyst - Post/Pre Pay Data Mining

Machinify is the leading provider of AI-powered software products that transform healthcare claims and payment operations. Each year, the healthcare industry generates over $200B in claims mispayments, creating incredible waste, friction and frustration for all participants: patients, providers, and especially payers. Machinify’s revolutionary AI-platform has enabled the company to develop and deploy, at light speed, industry-specific products that increase the speed and accuracy of claims processing by orders of magnitude.

Machinify is hiring a Healthcare Data Analyst for pre and/or post pay data mining to build new algorithms on behalf of Machinify’s customers. In addition, the Healthcare Data Analyst will assist in concept ideation, product testing, quality enhancements, and related tasks to ensure customer satisfaction.
The ideal person for this role has an extensive background in healthcare claims analysis, claims processing and coding, and a high level of understanding of payment guidelines for CMS, Medicaid and commercial payers.  They have a proven track record in SQL, Python, and like programs, utilizing large data sets to generate queries based on various requirements, policies and contract information.  Experienced in generating reports, data analysis, and problem solving in order to obtain optimal results.

What you'll do:

• Develop new healthcare data analytic concepts by utilizing experience and knowledge of the claims payment cycle, contracts, policies and guidelines. 

• Strong analytical skills with the ability to understand and break down complex issues, and apply in depth analysis to find a resolution.

• Collaborate with the claims analyst, data science and data engineering teams to understand needs to help shape business solutions and deliver results.

• Anticipate needs and proactively use analytic techniques to test accuracy of results and solutions to issues. 

• Develop new insights and iterate upon those insights to drive decisions, best practices and top quality results. 

• Quickly and efficiently deliver on query analysis requests from the Pay team 

• Remain updated with the latest billing guidelines and regulations.

• Design and deploy dashboards and data visualizations for the Pay department. 

• Identifies potential claims outside of the concept where additional recoveries may be available. Suggests and develops high-quality, high-value concepts and/or process improvement, tools, etc..

• Regularly perform data quality checks for accuracy, completeness, and consistency prior to sending results to the clients

• Act as liaison between healthcare SME team and data science and engineering teams. 

• Additional responsibilities as assigned or needed to support the business.

What you'll bring:

• 10+ years of relative experience working in healthcare data and data analytics.

• Has the ability to convert business requirements into technical requirements and convert that into functional code to deliver accurate results. 

• Proven experience in SQL or associated languages such as. R, Python, HIVE or Databricks.

• Knowledge of business intelligence tools such as Tableau/Power BI, etc.

• Ability to provide clear and concise written and verbal communication via various means, such as email, Slack, Teams, Zoom, etc. 

• Proven ability to use complex analytical, interpretive and problem-solving techniques to obtain desired results across clients and teams. 

• Proven ability to work under pressure to meet tight deadlines.  

• Ability to work in a fast paced environment, shift objectives, and perform multiple tasks at once.

• Ability to work independently and as part of a team.

• Willingness and ability to do whatever is necessary to accomplish workload demands.

• Delivery of high-quality work is critical.

• Strong attention to detail; investigative and deductive reasoning skills are a must.

• Must be able to make decisions and conclusions when working with limited information using reference materials and strong problem-solving skills.

• Must be proficient in using enterprise productivity and communication tools (e.g., Excel, Word, Gmail, Google Sheets, Slack, etc.); intermediate spreadsheet skills level critical, to include: ability to manipulate a spreadsheet, use formulas, work with pivot tables, run macros within existing spreadsheets; some training provided.

• Able to receive constructive feedback and maintain a positive attitude; must be flexible in dealing with change.

What we offer:

• Work from anywhere in the US! Our team is distributed and most of us work from home

• A flexible and trusting environment where you'll feel empowered to do your best work

• Hardworking and supportive colleagues and a leadership team that understands the importance of recruiting and retaining top talent

• Incredible Medical/Dental/Vision benefits for employees & their families.

• Competitive salary and equity, 401(k) sponsorship, life insurance

• Generous Learning and Development Reimbursement policy

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.

Our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes excellent healthcare, flexible time off, and other benefits and perks.

Equal Employment Opportunity at Machinify

Machinify is committed to hiring talented and qualified individuals with diverse backgrounds for all of its positions. Machinify believes that the gathering and celebration of unique backgrounds, qualities, and cultures enriches the workplace.