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.

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 Complex Payment Solutions team, you will, as a Nurse Itemized Bill Reviewer (IBR Analyst), be responsible for reviewing facility insurance claims to determine true and accurate charges. This role requires the analysis of the UB-04, the detailed itemized statement, and medical documentation when provided. The analyst will apply the client policy and industry standards when reviewing these claims. This role must identify billed items and services that do not meet the appropriate compliance guidelines. This role requires clinical expertise, as well as previous itemized bill review experience.

What you’ll do

Perform an in-depth review of medical claims utilizing the UB-04 and detailed itemized statement to ensure the validity of line-item charges.
Verify accuracy of the itemized charges to be reimbursed according to client policy and industry standards.
Validate automatic system denials and create additions to enhance efficient processing of IBR claims.
Recommend system enhancements and edits to improve claim review efficiency.
Comply with company standards regarding accuracy and productivity to manage daily assignments and meet client turnaround times.
Consult with Senior Analysts with any questions and/or issues related to claim reviews.
Assist in content development, automation, research, and appeal responses as needed.
Provide input and collaboration concerning content development with internal groups and on global projects as needed.
Attend all required meetings.
Assists in special projects and perform other duties as needed.

What experience you bring (Role Requirements)

Active RN, LPN, or LVN license in good standing
Equivalent experience of 1+ years in itemized bill review
Equivalent experience of 2+ years in healthcare billing and coding
Experience applying payer policies and national coding guidelines such as CPT, ICD-9/10, and HCPCS
Ability to research and verify billing and coding accuracy
Possess significant attention to detail and excellent written and verbal skills
Excellent organizational, analytical, and problem-solving skills
Capable of handling multiple projects in a fast paced, hyper-growth environment
Strong ability to work independently and work with internal teams communicating change across the business

Computer Equipment and Software:

Experience working with multiple monitors
Proven success in a remote working environment
Proficient in Windows office systems, including the full Microsoft Suite and Teams
Advanced skills in Microsoft Office (Excel, PowerPoint, Word)
Experience with various software applications and collaboration with development teams

What We Offer:

Work from anywhere in the US! Machinify is digital-first.
Top Medical/Dental/Vision offerings
FSA/HSA
Tuition reimbursement
Competitive salary, 401(k) with company match
Additional health and wellness benefits and perks
Flexible and trusting environment where you’ll feel empowered to do your best work

The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range.

Pay range: $80,000 - $90,000, with the opportunity to earn quarterly bonuses.

Equal Employment Opportunity at Machinify

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 let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

About the company

Machinify uses artificial intelligence to optimize decision-making in healthcare. It provides AI-driven applications that improve operational efficiency for health plans, payers, and providers, acting as a central nervous system to manage data-driven decisions. Its products streamline processes like claims processing and utilization management by deploying a growing portfolio of applications on the Machinify platform, designed for fast implementation and immediate ROI. Differences from competitors include an AI-first platform tailored to healthcare administration, a rapid deployment model, and a customer-focused approach that aims to deliver tangible results quickly. The company’s goal is to transform healthcare administration by reclaiming control over healthcare expenditures and improving efficiency and patient outcomes through data-driven decisions.

Company Size

1,001-5,000

Company Stage

Series A

Total Funding

$15.6M

Headquarters

Palo Alto, California

Founded

2016

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Simplify's Take

What believers are saying

July 2026 genetic testing launched with one Medicaid program finding $70 million savings.
Machinify now serves over 85 health plans and 270 million lives, per company materials.
Performant's October 2025 acquisition expands Machinify into government programs and broader recovery revenue.

What critics are saying

Axios reported July 24, 2026 that New Mountain Capital is shopping Machinify.
Rawlings, Apixio PI, and Performant integration still tests one brand and one operating model.
Audit-heavy payment recovery antagonizes providers, inviting appeals, scrutiny, and slower deployments.

What makes Machinify unique

Machinify spans prepayment, postpayment, recovery, and benefits coordination across payers.
Its July 2026 genetic-testing engine embeds InformedDNA expertise into payer policy workflows.
The October 2025 Performant deal fused AI software with audit-recovery operations and government access.

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Benefits

Medical, dental, & vision
Flexible work environment
Generous PTO
Competitive salary
Equity
401(k)
Sponsorship
Generous L&D Reimbursement policy

Growth & Insights and Company News

Headcount

6 month growth

1 year growth

16%

2 year growth

27%

IT Digest

Jul 14th, 2026

Machinify adds genetic testing expertise to its comprehensive payment intelligence platform.

Machinify adds genetic testing expertise to its comprehensive payment intelligence platform. Machinify announced a new genetic testing capability, extending the platform's intelligence into one of healthcare's fastest-growing and most clinically complex specialties. The expansion represents another step in applying Machinify's AI to increasingly sophisticated healthcare payment decisions, helping health plans address areas that have outpaced traditional payment integrity approaches. Genetic testing represents one of the fastest-growing and most clinically nuanced areas of healthcare, with more than 150,000 tests on the market today and more than 10 new ones introduced daily. The pace of innovation, combined with evolving evidence, coding structures, payer policies, and coverage requirements, makes the category particularly difficult to manage at scale. The capability builds on Machinify's acquisition of InformedDNA's genetic testing payment integrity business, encoding decades of specialized genetic testing review expertise directly into the Machinify platform. By combining AI with deep clinical expertise, Machinify enables health plans to make more informed decisions throughout the payment lifecycle, whether preventing incorrect payments before they occur or identifying overpayments downstream. "Precision medicine is generating more clinical complexity than any human review organization can keep up with, and genetic testing is the sharp edge of that," said David Pierre, CEO of Machinify. "We didn't build a genetic testing tool. We taught our AI to reason about genetic testing the same way it already reasons about the rest of the claim, with deep human expertise built in. That's the whole idea behind Machinify: as healthcare gets more complex, machine intelligence keeps the lead because every decision makes the next one smarter. That's how we bend the cost curve." The platform applies a specialized genetic testing knowledge base alongside each payer's medical policies to evaluate claims within their full clinical and contractual context. Grounded in Machinify's experience supporting Medicare, Medicaid, and commercial health plans, the models are developed, validated, and continuously governed by the company's board-certified geneticists and clinical experts. Every determination is transparent, defensible, and fully auditable. The approach is already delivering measurable results. In one Medicaid program, the capability identified more than $70 million in savings across reproductive and pharmacogenomic testing while improving the accuracy of payments for these services going forward. "Specialty areas like genetic testing are more important than ever; the science is evolving daily, and the spend has accelerated dramatically," said Tom Magnotta, President of Complex Payment Solutions at Machinify. "We are actively investing in and expanding our content on the platform. Genetic testing is just one of many areas where Machinify is deploying solutions to solve complex challenges for our clients using an AI-first approach." The genetic testing solution is available now to Machinify clients through the platform's real-time pre-payment solution or as a post-payment extension where retrospective recovery is required.

Associated Press

Jul 13th, 2026

Machinify adds genetic testing AI to payment platform, finds $70M in Medicaid savings

Machinify has launched a genetic testing capability on its payment intelligence platform for health plans. The expansion follows the company's acquisition of InformedDNA's genetic testing payment integrity business. The new capability uses AI combined with clinical expertise to help health plans manage payment decisions for genetic testing, one of healthcare's fastest-growing areas with over 150,000 tests currently on the market and more than 10 new ones introduced daily. The platform applies a specialised knowledge base alongside payer medical policies to evaluate claims. In one Medicaid programme, the capability identified over $70 million in savings across reproductive and pharmacogenomic testing. Machinify's platform is deployed by over 85 health plans, including many of the top 20, representing more than 270 million lives.

Dallas Next

Oct 21st, 2025

Dallas-Based Machinify Closes $670M Acquisition of Nasdaq-Listed Performant Healthcare

Dallas-Based Machinify closes $670M acquisition of nasdaq-listed Performant Healthcare. Machinify said that bringing together Performant's deep audit and recovery expertise with Machinify's advanced AI platform will enable the company to deliver faster, more accurate insights, further reduce administrative burden, and unlock greater savings for health plans. Left: Machinify CEO David Pierre; Right: Simeon Kohl, CEO of Performant Healthcare [Photos: LinkedIn/Performant] Dallas-based healthcare intelligence company Machinify has closed its acquisition of Plantation, Florida-based Performant Healthcare (Nasdaq: PHLT) for roughly $670 million. Machinify said the deal expands its AI-powered platform to reach a broader range of clients, including government programs, and accelerates its mission to simplify and modernize healthcare payments. With the acquisition, the New Mountain Capital-backed company closed its second major acquisition in 2025 to expand its AI-powered operating system to a broader range of clients. "We're thrilled to bring Performant into Machinify with such highly complementary assets," Machinify CEO David Pierre said in a statement. "Performant has built deep relationships in the government sector, which expands on Machinify's strong and expanding presence with national and regional payers. Together, we can offer our clients the most complete, data-driven platform for ensuring every healthcare dollar is used effectively." Machinify said that combining Performant's deep audit and recovery expertise with Machinify's advanced AI platform will enable the company to deliver faster, more accurate insights, further reduce administrative burden, and unlock greater savings for health plans. The integration enhances Machinify's ability to serve commercial and government payers with end-to-end intelligence, Machinify added, spanning claim error detection, prevention, recovery, and coordination of benefits. 'Supporting better outcomes' Performant CEO Simeon Kohl will remain with the company, joining the Machinify leadership team. Kohl said the acquisition comes at a key time in the industry. "I'm excited to join forces with Machinify at such a pivotal moment for the industry," Kohl said. "By combining our deep expertise with Machinify's AI platform, we'll be able to deliver even greater value to our clients - streamlining the payment process, improving accuracy, and supporting better outcomes across the healthcare system." "Performant strengthens Machinify's leadership as the next-generation platform for payment accuracy and intelligence," Matt Holt, managing director and president of private equity at New Mountain Capital, said in a statement. "This strategic integration aligns with Machinify's mission to make payments smarter, faster, and more transparent. We're excited about the significant value it will unlock for payers, providers, and the entire healthcare ecosystem." With the addition of Performant, Machinify said it now supports hundreds of millions of claims annually and delivers billions in savings through its unified AI and human-expertise model - helping clients reduce waste, improve provider relationships, and ensure accuracy from contracts to claims. Performant's shares will no longer be publicly traded and will be delisted from Nasdaq, as the company will now operate as a privately held entity. New York-based New Mountain Capital emphasizes business building and growth, rather than excessive risk, as it pursues long-term capital appreciation. The firm currently manages private equity, strategic equity, credit, and net lease real estate funds with more than $55 billion in assets under management. Track Dallas-Fort Worth's business and innovation landscape with its curated news in your inbox Tuesday-Thursday. R E A D N E X T. * AI Tinkerers Now Has a Dallas-Fort Worth Chapter: 'This Is for People Who Are Actually Using AI' Data scientist Anmolika Singh put Dallas on the global AI Tinkerers map. At the first meetup, more than 30 pros - founders to Fortune 500 technologists - showed up to trade ideas, projects, and solutions. * UT Dallas Study Tests AI as a Triage Tool in Breast Cancer Screenings Rather than replace radiologists, UTD researchers say AI could help flag low-risk mammograms for automated review. The approach could cut costs and ease delays as cancer rates rise and the diagnostic workforce shrinks. * With $4M Pre-Seed Funding, North Texas' Humancore Launches 'Multiplayer AI Advisor' Platform Plano-based Humancore describes its Multiplayer platform as an AI advisor that goes beyond traditional coaching and generic prompts by understanding not just the manager, but also their team. * Is Your Organization Ready for AI? Key Considerations to Assess AI Readiness Avoid common pitfalls with practical insights from guiding Fortune 500 companies through AI adoption * Caring for Its Elders, Intelligently: How Technology Can Bring Ease, Connection, and Better Health to Aging Americans Dallas is aging faster than ever, with seniors facing rising challenges of isolation, health, and care. Technology, when designed with empathy, can bridge these gaps - connecting families, empowering caregivers, and enabling prevention. By building tools with empathy, Dallas Next LLC can transform elder care from survival to peace of mind and joy.

Business Wire

Aug 2nd, 2025

Performant Healthcare, Inc. to Be Acquired by Machinify

Performant Healthcare, Inc. (Nasdaq: PHLT) (the “Company” or “Performant”), a leading provider of technology-enabled payment integrity, eligibility, and rela...

PE Hub

Jan 10th, 2025

New Mountain Capital to acquire healthcare tech firm Machinify

New Mountain Capital has agreed to acquire Machinify, a Palo Alto, California-based provider of artificial intelligence-powered software focused on healthcare payments.

Machinify

Nurse Itemized Bill Reviewer - IBR Analyst

About the job