Healthcare Data Analyst

Healthcare Data Analyst

Team: Healthcare

Reports To: Manager, Healthcare

Level: Analyst to Senior Analyst, depending on experience

Machinify builds the AI operating system for healthcare payment intelligence, combining the minds of industry experts with the power of technology. US healthcare wastes billions of dollars a year inside the claims payment workflow, and Machinify has built a platform to fix that, backed by more than 40 years of payment integrity expertise and a product suite spanning the full claims lifecycle from pre-pay through post-pay. Today, 85+ customers rely on us, including 18 of the top 20 US health plans, covering more than 270 million member lives across commercial, Medicare, and Medicaid. We process over 3 petabytes of claims data and return more than $6 billion in savings and recoveries to our customers every year, with 99% customer retention.

We're now opening a new hub in Bengaluru that isn't a satellite office or a support function: it's a genuine extension of one global Machinify, where local leaders run real teams and own real product and outcomes. The problems our teams solve are hard by design, which is exactly why they haven't been solved before, and why the work is worth doing. Joining now means building Machinify's India presence- its people, culture, and way of working- from the ground up, with real influence over what gets built and how.

Machinify's Healthcare team builds the logic that helps payers review healthcare claims accurately and efficiently. You own the numbers behind that work: the SQL, calculators, and AI prompts that pull values out of claims and medical records and test them against clinical criteria, with a focus on DRG and outpatient review. Nurses, physicians, and engineers bring the clinical judgment; you turn it into working logic. That logic runs across many payer clients, and a calculation that is slightly off can change the outcome of a claim review, so accuracy matters. You join a small team where your work is visible and you own what you build.

This role works with protected health information and requires HIPAA training.

• Build and maintain SQL and Spark SQL calculators and data extractions for DRG and outpatient clinical review.
• Write and refine prompts that extract and calculate values, dates, and measurements from medical records.
• Test your work against real cases and reviewer decisions. Find where it falls short and fix it.
• Configure, test, and deploy changes in our audit platform, and re-run cases when needed.
• Take work through clinical sign-off and user acceptance testing, then track how it performs in production.
• Partner with clinical subject matter experts, physician reviewers, data engineers, and a program manager to turn requirements into working logic.
• Document your logic so teammates can pick it up.

• Build: SQL and Spark SQL calculators, data extractions, and prompts, built from requirements with clinical subject matter experts and data engineers.
• Test: run against real cases and reviewer decisions. Find the gaps and fix them.
• Sign-off: clinical sign-off and user acceptance testing.
• Production: deploy in the audit platform, re-run cases when needed, and track performance.

Required

• 3+ years of advanced SQL experience, including Spark SQL.
• 2+ years in healthcare, payer, or clinical review, with a working knowledge of health insurance claims and medical records.
• Hands-on prompt engineering experience, including testing and measuring results.
• Can work through a new problem with an AI assistant in real time.
• Can work independently on a defined body of work.
• Clear communication with clinical and technical teammates.

Preferred

• Familiarity with DRG and outpatient payment methodologies, ICD-10, and CPT, or a coding credential (CCS, CPC).
• Experience with RAG systems or LLM evaluation.
• Background in payment integrity, audit, or clinical review operations.
• Experience with UAT and release processes.
• Data visualization experience.

Machinify is committed to providing equal employment opportunities and fostering an inclusive workplace. Employment decisions are based on business needs, job requirements, and individual qualifications, without discrimination on any status protected under applicable law. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiting team know.