Machinify
Content Innovation, Claims Editing - NY Medicaid (Multiple Levels)
Remote - US · Senior
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odds of building a lasting career here
Sponsors, but it's cap-subject — you still face the weighted lottery (~45% per draw at Level III). Good if you win; have a cap-exempt backup on your list.
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About the role
- 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.
- About the Opportunity Machinify is redefining Payment Integrity through smarter technology, richer data, and intelligent automation.
- This role will bring deep expertise in New York State Medicaid.
Responsibilities
- Document the source, rationale, and scope of every edit so it is traceable, defensible on appeal, and easy to maintain.
- Maintain existing content through quarterly code updates, policy changes, and performance reviews, and recommend when edits should be refined or retired.
- Validate content with data
- Use claims data to test editing concepts before build, size the opportunity, and estimate hit rate, false-positive rate, and savings.
- Partner with Product and Data Science
- Support clients and internal teams
- Support client policy review, edit approval, and appeals with clear, well-sourced documentation.
- Optimize for customer impact
- Deliver results
Requirements
- 7+ years of experience in claims editing, clinical coding, Payment Integrity, or payer policy, with hands-on experience authoring or validating edits.
- We participate in E-Verify as required by applicable law.
Compensation
- $135,000 - $165,000 USD
- This exempt position. The salary range is for Base Salary. Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee's geographic location.
- In accordance with applicable state laws, we do not inquire about salary history during the recruitment process.
Benefits
- 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.
Company info
- We are proud to be an equal opportunity workplace.
- If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know.
Visa & Work Authorization
- al 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
This listing is sourced directly from Machinify's careers page and normalized into a canonical job model.