Coordination of Benefits (COB) Analyst I

Who We Are

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify's AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We're reshaping healthcare payment through seamless intelligence.

Location: This position will be fully remote.

About the Opportunity

At Machinify, we're constantly reimagining what's possible in our industry-creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow. A COB Analyst I is an integral part of a dynamic team. A COB Analyst I is expected to validate information discovered during the data and enrichment process, verify the order of benefit determination is accurate, and identify potential claim overpayments for members covered by more than one health coverage. The Analyst also handles tasks including, but not limited to, invoice preparation, invoice follow-up, and file maintenance.

What you'll do

• Review and audit healthcare claims to ensure claims payments coordinated properly, utilizing Medicare and Commercial primacy rules.
• When necessary, effectively communicates with healthcare providers, employers, members, and/or insurance representatives to gather information.
• Resolve issues in a timely fashion.
• Utilize available resources to maximize identification and recovery of overpayments.
• Create, maintain, and close files in accordance with policies and guidelines.
• Deliver world class customer service and maintain professionalism in all aspects of communication.
• Actively seek to identify process improvements to increase workflow efficiency.

What experience you bring (Role Requirements)

• Bachelor's Degree or equivalent combination of experience in health insurance or related fields, which would provide the necessary knowledge, skills, and abilities to successfully perform the work.
• Very strong attention to detail, deductive reasoning, and organizational skills.
• Excellent oral and written communication skills, including on the phone, are required.
• Demonstrate integrity and honesty in all aspects of job performance.
• Ability to work well independently or in a team environment.
• Customer service experience highly preferred.
• Working knowledge of Word and Excel is required.
• Demonstrate integrity and honesty in all aspects of job performance.
• Experience in the healthcare field is helpful but not required.

What Success Looks Like...

After 3 months

• You will have a strong understanding of the role.
• You begin building relationships and collaborating with peers.
• You develop effective time and priorities management.
• You receive initial feedback about your performance and are using it to improve.
• You've gained confidence in your abilities and are starting to feel more comfortable in your role.

After 1 year

• You have mastered the tasks and responsibilities of the position, executing them with confidence and efficiency.
• You have established a strong network of internal relationships and are recognized as a key collaborator.
• You've been entrusted with greater responsibility indicating the company's confidence in your abilities.
• You see opportunities for career progression and personal development.

Pay range: This is an exempt position with an annual base salary of $62,000 with bonus opportunity.

What's in it for you

• 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.
• Remote and hybrid work options

What values we'll share with you

• Ask why
• Think big
• Be humble
• Optimize for customer impact
• Deliver results

At Machinify, we're reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity, teamwork, accuracy, and flexibility. We do the right thing, and we listen to the needs of our clients and their members. As tenured experts with unmatched experience, we champion diverse perspectives that help us to better understand and serve our clients.

Our values come to life through our culture. We embrace flexible working arrangements that allow our employees to bring innovation to life in the way that best suits their productivity. We work cross-functionally, abandoning silos, to bring innovative and accurate solutions to market. We invest in each other through ongoing education and team celebrations, and we give back to our communities through dedicating days for volunteering. Together, Machinify is making healthcare work better for everyone, and we're passionate about a future with better outcomes for all.

We are committed to equal 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. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please contact our People Operations team at machinify_careers@machinify.com. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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