Coordination of Benefits (COB) Recovery Analyst II

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. As part of the COB Recovery team, you will be a part of a dynamic teams, specializing in refund maximization. Once a coordination of benefits overpayment has been confirmed, a COB Recovery Analyst II works to facilitate the refund of overpayments from healthcare providers by sharing coordination of benefits knowledge and through persuasive communication. This communication takes place primarily through inbound and outbound calls to providers and insurers. In addition, we strive to create relationships with providers and clients to streamline the recover process. The Recovery Analyst will also handle other administrative duties to remain current on their accounts.

What you’ll do

• Contact healthcare providers and insurance carriers to explain coordination of benefits on patient accounts.
• Build and maintain provider relationships and establish more streamline communication processes to increase recoveries and reduce uncooperative closures.
• Facilitate recovery efforts within defined Client workflows.
• Contact healthcare providers and insurance carriers to explain coordination of benefits on patient accounts.
• Coordinate claims billing to the insurance carrier and assist in responding to appeals and/or claim denials.
• Coordinate the provider refunds in accordance with training guidelines.
• Maintains detailed records regarding all activities and communication on patient accounts.
• Effectively determine when to escalate recovery issues to a higher level.
• Effectively communicates issues and concerns with peers and leadership.
• Actively seeks to identify process improvements to increase workflow efficiency
• Understands Medicare and Commercial primacy rules.

What experience you bring (Role Requirements)

• Excellent oral and written communication skills are required, including a significant amount of provider/physician contact on the phone.
• Customer service experience highly preferred.
• Ability to work independently or in a team environment.
• Very strong attention to detail and organizational skills.
• Word and Excel proficiency is preferred.
• 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 $57,500 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/

#INDHP