Carrier to Carrier Support Specialist

Who We Are

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 60 health plans, including many of the top 20, and representing more than 160 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.

Location: Opportunity to work full remote after training.

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 Payment Integrity Carrier to Carrier team, The Support Specialist will be responsible for assisting team members with administrative tasks related to the billing and recovery of medical claims. The specialist must possess a general understanding of the medical billing and recovery process.

What you'll do

• Daily monitoring of check and document queue, updating metrics with check information and routing denials to the recovery team.
• Record check activity to the appropriate spreadsheets.
• Involved in the printing and production of paper claims and mailing to the appropriate payers.
• Scanning in documentation and attaching to the appropriate work system.
• Archiving closed files in Clearinghouse.
• Attend to all Medical records requests, pull applicable records for Recovery team.
• Monitor Carrier to Carrier Report claim statuses to verify status in other systems.

• Associate degree or equivalent combination of experience in health insurance or related fields, which would provide the necessary knowledge, skills and abilities to successfully perform the work.
• General understanding of Medical Billing and recovery.
• Advanced Excel and MS Word required, including prioritizing, and organizing data.
• ACT and Smart experience and understanding.
• Ability to work well independently or in a team environment.
• Very strong attention to detail, organizational skills, and excellent time management skills.
• Good oral and written communication skills, including excellent phone communication skills.
• Ability to multi-task and work independently as required.

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: $22.00 - $24.00 hourly wage. 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

At Machinify, we're reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity, teamwork, accuracy, and flexibility. We do the right thing, and we listen to the needs of our clients and their members. As tenured experts with unmatched experience, we champion diverse perspectives that help us to better understand and serve our clients.

Our values come to life through our culture. We embrace flexible working arrangements that allow our employees to bring innovation to life in the way that best suits their productivity. We work cross-functionally, abandoning silos, to bring innovative and accurate solutions to market. We invest in each other through ongoing education and team celebrations, and we give back to our communities through dedicating days for volunteering. Together, Machinify is making healthcare work better for everyone, and we're passionate about a future with better outcomes for all.

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 contact our People Operations team at peopleoperations@rawlingscompany.com. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/