Pharmacy Payer Recovery Analyst

Who We Are

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 60 health plans, including many of the top 20, and representing more than 160 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.

Location: This position will be hybrid, with opportunity to work full remote after training as well as in our La Grange, KY office.

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 Pharmacy Payer-to-Payer team, you will manage the pharmacy claim recovery process on behalf of Rawlings’ legacy clients.

What you’ll do

• Collaborate with payers to establish and enhance reconciliation processes.
• Think critically and analyze outcomes to support the development of process improvements that increase the effectiveness of recovery efforts.
• Develop and generate team reporting.
• Develop and maintain process documentation.

What experience you bring (Role Requirements)

• Bachelor's degree or 2 - 3 years of directly applicable experience
• Excellent work ethic
• Strong analytical skills with experience organizing and summarizing data and preparing analysis and recommendations.
• Critical thinking, creativity and problem-solving skills; ability to propose viable solutions
• Must work well on a team and individually with the ability to plan and schedule activities to accomplish objectives in a dynamic environment
• Experience with MS Office Suit, specifically the use of Pivot Tables and V-Lookup
• Ability to write, edit and understand SQL Select Queries.
• Experience with lean and Six Sigma process development concepts preferred
• Experience in the pharmacy benefit management, health insurance, and/or accounts receivable management industries preferred

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.