Machinify

Machinify

Senior Contract Analyst

Remote - US · Senior

Sponsorship not specifiedDetected 13 days ago
Data VisualizationExcelAuditingContract ManagementCadenceLeadershipCommunicationAdaptability

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Cap-exempt (no lottery)0
Sponsors this role90
Entry-level history0
PERM / green-card track0
Lottery odds40
Fits your clock70

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Files H-1B transfers

17 transfer filings in the last year, covering 17 workers. Median labor-condition decision: 7 days. An employer that already files transfers is one that can take over an existing H-1B.

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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.
  • The Senior Contract Analyst is responsible for ensuring the outpatient and specialty audit teams operate from correct, current payer-provider contracts and payer reimbursement policies.
  • This is a senior individual contributor role requiring independent judgment, good judgment and decisive action in complex or evolving situations, and sound escalation practices.

Responsibilities

  • Validate that audit teams have the correct contract version, amendments, fee schedules, and effective dates before audits are performed.
  • Build and maintain a contract inventory with version control, renewal tracking, and a clear audit trail of changes.
  • Identify missing, expired, or outdated contracts and drive resolution before audit work is affected.
  • Partner with audit leadership and policy teams to surface new concept opportunities found in contract terms.
  • Identify policy gaps before a concept is implemented for a client and drive resolution with Client Success and the client.
  • Maintain linkage between each concept, its supporting policy, and the client to ensure audit findings are supported by current, defensible policy.
  • Own and maintain the concept matrix mapping which outpatient and specialty audit concepts are active, paused, or excluded for each client.
  • Establish update cadence, change control, and quality checks to maintain matrix accuracy for Ops, Client Success, and leadership.
  • Identify process improvements and support scaling of the contract intake and abstraction workflow as the client base grows.

Requirements

  • Bachelor's degree or equivalent professional experience.
  • Experience with specialty audit areas such as implants, high-cost drugs, or infusion services.
  • Familiarity with contract management platforms and data visualization tools.
  • We participate in E-Verify as required by applicable law.
  • Required
  • 5+ years of experience in healthcare payment integrity, provider contracting, managed care, claims auditing, or revenue cycle.
  • Demonstrated ability to read, interpret, and abstract payer-provider contract terms and reimbursement methodologies.
  • Strong working knowledge of outpatient reimbursement, including OPPS/APC, fee schedules, percent of charges, and carve-out structures.
  • Working knowledge of payer reimbursement policies and the ability to connect policy language to audit concepts.
  • Familiarity with AI tools such as Claude to support contract, policy, and payer research.
  • Advanced Excel skills and experience building and maintaining complex tracking tools or matrices.
  • Preferred
  • Coding or clinical credential (CPC, CCS, RHIA, RHIT, or RN).
  • Experience in a payer, payment integrity vendor, or health system contracting department.

Compensation

  • In accordance with applicable state laws, we do not inquire about salary history during the recruitment process.

Benefits

  • Serve as the single source of truth for payer-provider contracts and reimbursement policies supporting outpatient and specialty audit programs.
  • Maintain the library of payer reimbursement policies supporting outpatient and specialty audit concepts, ensuring the required policies are in place to implement each concept for each client.
  • Payer Reimbursement Policy Management
  • Ensure the matrix reflects client-specific contract terms, supporting reimbursement policies, exclusions, and approvals.
  • Provide reporting and insight on concept coverage gaps and expansion opportunities by client.
  • Serve as the primary contract intelligence partner to Client Success teams, providing clear, specific requests to obtain updated contracts, reimbursement policies, and related information from each client.

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
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This listing is sourced directly from Machinify's careers page and normalized into a canonical job model.