---
title: 'Medical Appeals Specialist (SCA) at Machinify'
canonical: 'https://feeny.ai/job/medical-appeals-specialist-sca-machinify-united-states-qy0g3h0edac0'
type: 'job'
last_seen: '2026-09-09'
---

# Medical Appeals Specialist (SCA) at Machinify

- **Company:** Machinify
- **Location:** United States
- **Work type:** remote
- **Posted:** 2026-08-20
- **Last confirmed live:** 2026-09-09
- **Apply:** https://job-boards.greenhouse.io/machinifyinc/jobs/4376403009

## Job description

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 Appeals Specialist performs reconciliation of appeals received from the Provider/MAC, as well as serving as a critical point of contact between the MAC and other internal departments within Performant. As the Medical Appeals Specialist, you will work in a fast-paced and dynamic environment and be part of a multi-location team. The successful candidate will be a team player able to collaborate with a variety of different entities to solve problems and generate solutions.

What You’ll Do:

- To accurately receive, review, and forward appeal documents and requests, ensuring that all federal and state regulations, contractual compliance, and company guidelines and standards are met.
- Process all appeal documents and requests efficiently and accurately.
- Upload media to accounts and ensure uploads are successful.
- Distributes designated media to other departments as appropriate.
- Meet daily/weekly production standards.
- Provide recommendations to department management on workflow and process improvements towards efficiency, accuracy, and streamlining whenever possible.
- Complete accurately and efficiently all tasks as assigned by department management.
- Perform other incidental and related duties as required and assigned.

What You Bring:

- High School diploma or GED required
- 5+ years in relevant office/administrative/support environment roles with progressive complexity, preferably in healthcare-related business.
- Demonstrated knowledge of healthcare audit, appeals processes, claim processing, billing, and recovery processes and practices (Medicare and Medicaid working knowledge strongly preferred).
- High level of ability in multi-tasking and prioritizing workload.
- Must have flexibility and be able to adapt to ever-changing needs and requirements.
- Intermediate MS Excel and MS Word skills.
- Strong knowledge of medical documentation.
- Able to meet or exceed deadlines.
- Ability to maintain high quality of work while meeting strict deadlines.
- Able to work efficiently, independently, and complete any/all workload as assigned by department management.
- Strong communication in both verbal and written business language skills.
- Courteous, professional, and respectful attitude.
- Responsible, dependable, conscientious, detail-oriented, and reliable.

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: $21.00/hr.

## 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 Machinify

## Company Overview

- **One-liner**: Machinify uses artificial intelligence (AI) to improve healthcare payment integrity, reducing costs and ensuring accurate claims processing for health plans.
- **Entity Type**: Private (Acq – Fin stage; investors include New Mountain Capital, Matrix Partners, Battery Ventures, GV)
- **Headquarters**: Palo Alto, California, United States
- **Founded**: 2015 (per CBInsights) or 2016 (per Built In)
- **Founders**: Not publicly available from provided sources

## Core Business

- **Primary industry**: Healthcare IT – Payment Integrity & Analytics
- **Target customers**: B2B, serving health plans (commercial, Medicare, Medicaid) – 85+ customers including 18 of the top 20 health plans
- **Mission/purpose**: “Reshaping healthcare payment through seamless intelligence” – improving performance and affordability for the entire healthcare ecosystem

## Products & Services

- **AI Operating System for Payment Integrity**: A platform that includes foundation models trained on billions of healthcare data points, a unified data layer (claims, medical records, contracts, policies), task‑specific intelligent agents, and feedback loops for continuous improvement.
- **Payment Integrity Solutions**: Products cover the full spectrum of payment integrity interventions (e.g., DRG review, outpatient audit, subrogation, specialty recovery, claims editing). Deployment models include fully insourced, hybrid, or fully managed.

## Market Standing

- **Valuation / Market Cap**: Not disclosed
- **Key Metric**: Total funding $10.68M (latest round: Acq – Fin; investors include New Mountain Capital, Matrix Partners, Battery Ventures, GV, Paycheck Protection Program, and others)
- **Notable Investors/Partners**: New Mountain Capital, Matrix Partners, Battery Ventures, GV (Google Ventures)
- **Growth Signals**:
  - 85+ customers, including 18 of the top 20 health plans
  - Covers 270M member lives across commercial, Medicare, and Medicaid
  - Over $6B in annual cost avoidance and recoveries realized
  - Currently posting ~48 open roles on Greenhouse (as of search date)

## Competitive Advantages

- **AI‑native platform** trained on billions of healthcare data points, combining foundation models, unified data, and task‑specific agents for high‑precision results
- **Deep domain expertise** – the team brings 40+ years of combined experience in healthcare payment accuracy
- **Flexible deployment** (insourced, hybrid, fully managed) adapts to customer strategy
- **Proven scale** (270M member lives, top health plans) demonstrates trust and effectiveness

## Strategic Focus

- **Expanding payment integrity interventions** across the full care continuum (commercial, Medicare, Medicaid)
- **Continuous improvement** through human‑in‑the‑loop feedback loops
- **Investing in AI safety and transparency** while scaling platform capabilities

## Why Work Here

- **Culture**: Values-driven (Think Big, Be Humble, Deliver Results, Ask Why, Optimize for Customer Impact); transparent, collaborative environment
- **Work model**: Fully remote roles available (US‑based), with some roles requiring onsite presence in Palo Alto, La Grange (KY), or Hendersonville (TN). Hybrid schedules are also supported.
- **Technology stack**: Rust, machine learning, large language models, data engineering, cloud processing
- **Career opportunities**: Open positions across Engineering (Rust, Frontend, Backend, Fullstack, Platform), Data Science (NLP, Modeling, Agentic Systems), Product Management, Operations, Clinical & Coding Auditors, and more
- **Perks**: Mission‑driven work with direct impact on healthcare affordability; strong emphasis on accountability and trust

> **Note**: Machinify warns of active hiring scams – legitimate communications always come from official company email addresses and never require payment.

## Sources

1. [machinify.com](https://www.machinify.com/) – Company overview, products, mission
2. [machinify.com/careers](https://www.machinify.com/careers/) – Culture, values, work model
3. [job‑boards.greenhouse.io/machinifyinc](http://job‑boards.greenhouse.io/machinifyinc) – Current job listings (48 roles)
4. [cbinsights.com](https://www.cbinsights.com/company/machinify) – Funding, stage, investors, headquarters, founding year
5. [builtin.com](https://builtin.com/company/machinify) – Office locations, employee count (96), remote/hybrid policy, technology stack

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