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.

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