Senior Analyst (Data mining)
Machinify(2 months ago)
About this role
The Senior Analyst (Data Mining) at Machinify leads the development and refinement of reimbursement concepts by analyzing claims data and provider contracts to identify payment inaccuracies. This role requires deep knowledge of reimbursement logic and collaboration with technical teams to translate complex scenarios into structured business rules. Responsibilities include conducting claim reviews, documenting reimbursement patterns, and supporting quality improvement initiatives, all aimed at enhancing payment integrity in healthcare.
Required Skills
- Reimbursement Logic
- Payment Policies
- Provider Contracts
- Claims Data
- Payment Errors
- Analytical Frameworks
- Contract Analysis
- Claims Processing
- Billing Practices
- Root Cause Analysis
+5 more
Qualifications
- 5+ years experience in healthcare data mining or claims editing
- Coding or billing certifications
- Working proficiency in SQL
About Machinify
www.machinify.comMachinify is a cutting-edge healthcare technology company dedicated to simplifying and enhancing payment processes within the healthcare industry. By leveraging advanced AI and machine learning, Machinify delivers high-precision solutions that optimize financial outcomes and reduce costs for healthcare organizations. Their platform seamlessly integrates a wide range of financial interventions, providing enhanced data clarity and operational efficiency to both payers and providers. With a strong commitment to innovation, Machinify serves a diverse clientele, including many of the top health plans, aiming to improve overall patient care through smarter payment integrity solutions.
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