Develop, maintain, test, and optimize payment integrity audit concepts for durable medical equipment, home health, and home infusion claims, ensuring alignment with coding standards, payer policies, and regulatory requirements. Support audit operations through policy guidance, training, analytics, client collaboration, quality assurance, and workflow improvements. Requires a bachelor’s degree or equivalent experience, at least five years of relevant post-acute services experience (or three years in post-acute claims or recovery auditing), and a nationally recognized nursing or coding credential. Candidates should have deep knowledge of post-acute coding, Medicare and Medicaid payment policies, audit concept development, data analysis, and strong communication and workflow management skills.
Machinify provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
