[Hiring] Senior Healthcare Data Analyst @Machinify

Role Description

Machinify is rebuilding how health plans audit and pay claims — at scale, with AI. As a Senior Healthcare Data Analyst, you will sit at the intersection of domain expertise and data engineering:

• Translating raw claims feeds into trusted canonical models.
• Driving payment integrity insights.
• Serving as the internal expert on how claims flow through adjudication.

This role is for someone who knows healthcare data cold and is excited to pair that knowledge with modern AI tooling to move faster and build smarter.

Qualifications

• Bachelor's degree in Business, Computer Science, Health Informatics, or a related field.
• 5+ years working directly with healthcare claims data — 837 EDI, encounter data, medical billing — ideally at a health plan, payment integrity vendor, or healthcare analytics firm.
• Deep knowledge of claim types (professional and institutional), coding systems (ICD-10-CM/PCS, CPT, HCPCS), and standard form formats (UB-04, CMS-1500).
• Hands-on payment integrity experience: overpayment detection, COB, billing edits, or claim editing logic.
• Familiarity with CMS regulations and commercial payer guidelines as they apply to claims adjudication and payment policy.
• Advanced SQL proficiency; comfortable writing complex analytical queries against large datasets.
• Solid understanding of data modeling concepts and best practices for analytics.
• Strong communicator — able to discuss healthcare process and payment logic directly with health plan clients, clinicians, and non-technical stakeholders.
• Self-starter with strong ownership, accountability, and the ability to manage multiple concurrent initiatives.

Requirements

• Working knowledge of provider reimbursement methodologies — MS-DRG/APR-DRG pricing, fee schedules, per diem, and capitation.
• Proficiency with Spark SQL or a comparable distributed query engine for large-scale data environments.
• Exposure to ETL/ELT pipeline development or close collaboration with data engineers on pipeline design.
• Exposure to value-based care arrangements or risk adjustment (HCC coding, RADV).

Benefits

• Work from anywhere in the US! Machinify is digital-first.
• Full Medical/Dental/Vision for employees & their families.
• Flexible and trusting environment where you’ll feel empowered to do your best work.
• Unlimited FTO.
• Competitive salary, equity, 401(k) including employer match.
• The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc.
• We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range.
• The base salary range for this role is $140,000 - $170,000 plus private equity.

Company Description

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. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise.

We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.