Senior Data Analyst

Role Description

We're seeking a Senior Data Analyst to join our Data Engineering team who brings three things together:

• Deep healthcare domain expertise that lets you engage health plan clients directly on payment and process questions.
• The ability to quickly learn and work across Machinify's internal products — from data ingestion through claims adjudication.
• A drive to develop and build AI-driven workflows that continuously raise the bar on what our analyst function can do.

This is not a pure back-office role — you'll be the bridge between client needs, internal product knowledge, and data-driven outcomes.

What You’ll Do

• Collaborate with clients and internal stakeholders to understand payment integrity requirements, document process flows, and integrate analytical outputs with client workflows and downstream adjudication systems.
• Develop deep understanding of Machinify's internal processes and how they integrate together — from data ingestion through claims adjudication — ensuring analytical solutions are accurate, traceable, and aligned with business needs.
• Actively drive AI adoption: prompt and iterate with LLMs to accelerate analysis, identify processes where AI can replace manual workflows, and contribute to AI-assisted pipeline development.
• Write and maintain complex analytical SQL against large-scale claims datasets: window functions, CTEs, multi-table joins, query optimization, and production-quality logic that runs reliably at scale.
• Identify and build AI-driven automation workflows that replace or accelerate manual analytical processes — moving from one-off prompts to repeatable, team-shareable tooling.
• Design and implement data transformations that convert raw medical and institutional claims into canonical models, applying healthcare coding standards (ICD-10, CPT, HCPCS, UB-04, CMS-1500) throughout.
• Drive payment integrity analysis — identify overpayment patterns, coordination of benefits issues, and billing edit opportunities by applying deep knowledge of payer policy, CMS regulations, and provider reimbursement methodologies.
• Conduct data quality audits and build monitoring frameworks that surface anomalies before they reach production.
• Support onboarding of new client data feeds, ensuring smooth integration with minimal disruption.
• Partner with engineers, clinical staff, and product managers to translate complex healthcare requirements into data solutions.
• Mentor analysts and engineers on healthcare domain questions — serving as the go-to SME on coding, claims adjudication, and payer policy.
• Document transformation logic, data lineage, and analytical methodologies to support knowledge transfer and audit readiness.

Qualifications

• 5+ years of data analysis experience and working directly with healthcare claims data.
• Deep knowledge of medical claim types (professional and institutional), coding systems (ICD-10-CM/PCS, CPT, HCPCS), and standard form formats (UB-04, CMS-1500).
• Demonstrated experience using LLMs or AI tools to accelerate analytical work — not as a novelty, but as a repeatable part of your workflow.
• Expert-level SQL: complex analytical queries, window functions, CTEs, performance tuning against datasets of hundreds of millions of rows.
• Hands-on payment integrity experience: overpayment detection, COB, billing edits, or claim editing logic.
• Familiarity with CMS regulations and commercial payer guidelines as they apply to claims adjudication and payment policy.
• Strong communicator — able to discuss healthcare process and payment logic directly with health plan clients and non-technical stakeholders.
• Ability to translate ambiguous business and clinical requirements into precise, well-documented data logic.
• Working knowledge of provider reimbursement methodologies — MS-DRG/APR-DRG pricing, fee schedules, per diem, and capitation.
• Proficiency with Spark SQL or a comparable distributed query engine — writing and optimizing queries against large-scale data environments is a daily expectation.
• Experience with Databricks or a cloud data lakehouse (Delta Lake, Snowflake, BigQuery).
• Background in ETL/ELT pipeline development or close collaboration with data engineers on pipeline design.
• Exposure to value-based care arrangements or risk adjustment (HCC coding, RADV).
• Prior experience at a health plan, payment integrity vendor, or healthcare analytics firm.

Benefits

• Work from anywhere in the US! Machinify is digital-first.
• Full Medical/Dental/Vision for employees & their families.
• Flexible and trusting environment where you’ll feel empowered to do your best work.
• Unlimited FTO.
• Competitive salary, equity, 401(k) including employer match.
• 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. The base salary range for this role is $140,000-$170,000.
• We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range.
• Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks.