Machinify
Audit Policy Analyst, Post-Acute Services
Remote - US · Senior
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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.
- Machinify is an employment at will employer.
- In accordance with applicable state laws, we do not inquire about salary history during the recruitment process.
Responsibilities
- Perform QA reviews of audit concepts to confirm compliance with regulatory, coding, and citation changes and to confirm updates are applied timely.
- Identify discrepancies in concept performance and drive resolution with clinical, coding, and operations teams.
- Maintain organized, accessible documentation of post-acute audit policies and concept updates.
Requirements
- Manage, track, and progress multiple tasks across concurrent audit concept workflows with a high degree of accuracy and quality, delivering results on time.
Compensation
- Review and update existing audit concepts on required periodic cycles or in response to client or regulatory changes, including quarterly HCPCS updates, DMEPOS fee schedule updates, and annual Home Health PPS final rules.
Benefits
- Develop new post-acute audit concepts for DME, home health, and home infusion therapy claims, including research, data and claim analysis, rule documents, and code lists.
- Serve as the escalation point for auditors and clinical reviewers on complex DMEPOS, home health, and home infusion documentation and coverage questions.
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.