Machinify

Machinify

Training Specialist, Medical Review Audit – Clinical RN

Remote - US · Mid

Sponsorship not specifiedDetected 57 days ago
PHPExcelOperations ManagementProcess ImprovementOnboardingICD-10CollaborationMicrosoft Office

Stay score

odds of building a lasting career here

40Risky
Cap-exempt (no lottery)0
Sponsors this role90
Entry-level history0
PERM / green-card track0
Lottery odds40
Fits your clock70

Thin sponsorship signal and lottery-bound. A low-probability bet with your clock running. Prioritize cap-exempt roles and proven entry-level sponsors first.

Lottery odds assume a STEM candidate.

Personalize to your clock →

Employer immigration record

from this employer's Department of Labor filings

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.

Sourced from Department of Labor LCA, PERM and prevailing-wage disclosure data. Employer matching is by name, so figures may be split across an employer's legal entities. Absence of a filing means none appears in our copy of the data, not that none exists.

Community outcomes

No reports yet — be the first to help the next applicant.

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.
  • This role requires an active nurse who can function as both a clinical subject matter expert and a skilled adult learning practitioner.
  • Clinical Subject Matter Expertise - Serve as the primary subject matter authority for IPF audit training, including: inpatient psychiatric medical necessity criteria (vs.

Responsibilities

  • Develop structured training programs, job aids, reference materials, and assessment tools for new hire onboarding, ongoing competency, performance improvement, and new program implementations.
  • Maintain and update training materials on a continuous basis to reflect changes in CMS payment rules, LCD/NCD policy, coding guidelines, and client-specific requirements affecting IPF and IRF audits.
  • Track and report training completion, assessment scores, and post-training performance metrics (audit accuracy, QA results, appeals outcomes); use data to evaluate program effectiveness and drive continuous improvement.
  • Identify training gaps through QA results, audit performance data, appeals trends, and direct observation; develop and execute targeted remediation plans.
  • Deliver training on new client implementations, new audit programs, and updated audit concepts in coordination with operations and management.
  • Provide consultative input on audit platform requirements, workflow design, and business rule development as they relate to IPF and IRF audit processes.
  • Partner with operations management, QA, and compliance to align training programs with business objectives and client contractual requirements.

Requirements

  • Proficiency with ICD-10-CM/PCS coding for inpatient psychiatric and rehabilitation claims
  • working knowledge of DRG and CMG assignment logic.
  • Familiarity with utilization management tools such as MCG or InterQual, particularly criteria applicable to inpatient psychiatric and rehabilitation level of care determinations.

Nice to have

  • AHIMA or AAPC coding certification preferred (CPC, CCS, CCS-P, RHIT, or equivalent).
  • Direct clinical experience in an inpatient psychiatric or inpatient rehabilitation setting preferred
  • this experience must be reflected in the candidate's nursing background, not only their audit history.
  • Clinical background in inpatient psychiatric nursing, including familiarity with psychiatric assessment tools (PHQ-9, Columbia Suicide Severity Rating Scale, etc.), treatment planning, and level of care criteria.
  • Clinical background in inpatient rehabilitation nursing, including familiarity with FIM scoring, functional goal-setting, and IRF care coordination.
  • Prior experience in a RAC, MAC, TRICARE, or commercial payer audit environment focused on inpatient facility claims.
  • Experience conducting User Acceptance Testing on audit platform or reporting system enhancements.
  • Equal Employment Opportunity at Machinify

Compensation

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

Benefits

  • Plan, coordinate, and deliver new hire training and ongoing education across 1:1, small group, and virtual classroom formats.
  • Monitor changes to CMS regulations, LCD/NCD coverage criteria, coding guidelines, and clinical standards; proactively update training content and communicate changes to audit staff.
  • Build and manage training content within the Learning Management System (LMS); ensure materials are current, accessible, and structured for effective delivery in a remote environment.

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
Apply directly at Machinify →Create a free account for alerts like thisView Machinify immigration profile

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