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.
The Medical Director serves as a clinical subject matter expert and physician leader for an audit organization supporting governmental and commercial payer programs. This role provides medical oversight for audit strategy, clinical review methodologies, coding and documentation interpretation, claims validation, medical necessity determinations, and appeal support. The Medical Direct... Click Apply to read the full job description.