Machinify
IBR Policy and Content Development Analyst
Remote - US · Mid
Sponsorship not specified$11k-$85kDetected 2 days ago
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odds of building a lasting career here
39Risky
Cap-exempt (no lottery)0
Sponsors this role90
Entry-level history0
PERM / green-card track0
Lottery odds (Level I)39
Fits your clock70
Thin sponsorship signal and lottery-bound (~15% per draw). A low-probability bet with your clock running. Prioritize cap-exempt roles and proven entry-level sponsors first.
Lottery odds assume a STEM candidate.
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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 We're seeking a skilled IBR Policy and Content Development Analyst to join our team!
- You will be responsible for the development, enhancement, and performance of clinical and coding solutions.
Responsibilities
- Conduct research and analysis to identify the impact of regulatory, coding, or payer policy changes on existing concepts and document findings accordingly.
- Develop, validate, and maintain audit concepts targeting coding unbundling in accordance with NCCI edits.
- Identify discrepancies in concept performance and drive resolution with clinical, coding, and operations teams.
- Participate in testing for new concepts to verify that the automated logic performs accurately in the system environment before implementation.
- Collaborate with cross-functional teams to develop clinical and coding solutions, audit strategies, and payment integrity initiatives and policies.
- Support ongoing enhancements to concept tracking and cross-function coordination.
- Leverage AI tools and automation to optimize policy development, streamline research, and scale payment integrity solution performance.
- Perform additional responsibilities and ad hoc projects as assigned to meet business needs.
Requirements
- 3+ years' experience performing payment integrity or auditing facility claims.
- Knowledge of national coding standards, particularly payment rules.
- Demonstrated experience or proficiency in utilizing AI tools and automation platforms to optimize clinical research.
- Proven ability to communicate effectively with all levels of the organization, with diverse teams, and with clients.
- Ability to prioritize and multitask.
- Required Skills/Qualifications:
- We participate in E-Verify as required by applicable law.
- Experience translating complex medical regulations and payer guidelines into clear, legally compliant clinical content and structured policy documentation.
- Deep understanding of Medicare and Commercial coding rules, regulations, and prospective payment systems.
- Broad knowledge of medical claims billing/payment systems, provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology.
- Strong organizational and written communication skills.
- In-depth knowledge of diverse facility reimbursement methodologies and commercial/government payment policies to ensure accurate contract compliance and audit integrity.
- Proficient in Windows office systems, including the full Microsoft Suits (Excel, Word, Outlook, PowerPoint, SharePoint, and Teams).
- License/Certification
- At least one of the following coding certificates:
Compensation
- Competitive salary, 401(k) with company match
- $85,000 - $110,00 USD
- 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
- Top Medical/Dental/Vision offerings
- Tuition reimbursement
- Additional health and wellness benefits and perks
- Flexible and trusting environment where you'll feel empowered to do your best work
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.
- We are proud to be an
Equal opportunity
- equal opportunity workplace.
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.