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Job Overview
Location
United States (Remote)
Job Type
Full-time
Category
HR & Recruiting
Date Posted
March 25, 2026
Full Job Description
đź“‹ Description
- • The Healthcare Billing Recovery Case Specialist I (SCA) role at Performant Corporation, now part of Machinify, is critical to recovering improperly paid Medicare funds by identifying and resolving billing discrepancies under the Medicare Secondary Payer (MSP) program. This position directly contributes to Machinify’s mission of delivering unmatched value, transparency, and efficiency in healthcare payment integrity by ensuring health plans recapture overpayments and maintain compliance with federal regulations.
- • Day-to-day responsibilities include reviewing healthcare claims and supporting documentation to verify payment liability for claims potentially paid in error by Medicare; leveraging expertise in medical billing, Coordination of Benefits (COB), Third Party Liability (TPL), and MSP to build case files, validate liability, evaluate defenses, and initiate appropriate correspondence with insurers, carriers, or legal representatives to recover funds.
- • Specialists update client and internal systems with accurate contact information, demographic updates, contact notes, payment commitments, and account status changes; initiate and follow through on claim activities to ensure timely and accurate documentation per policies and procedures; and support internal teams by interpreting Explanation of Benefits (EOB) and contributing to knowledge base development on healthcare billing concepts.
- • The role requires strict adherence to company, departmental, and client policies, including HIPAA compliance, utilization of resources to meet regulatory requirements, completion of assigned training, and consistent achievement or exceeding of production and quality metrics.
- • Employees must maintain reliable, secure high-speed internet for remote work, comply with Teleworker Agreement terms, and be prepared to work overtime or on holidays as required by client needs; they are also responsible for obtaining and maintaining client-mandated clearances and passing regular background and drug screenings as a condition of employment.
- • The position demands strong interpersonal and communication skills to interact professionally with providers, carriers, beneficiaries, and internal stakeholders; self-motivation, attention to detail, and the ability to work independently and collaboratively in a fast-paced environment while adapting to changing assignments, processes, and regulations.
- • Machinify, formed after Machinify’s acquisition of Performant in October 2025, is a leading healthcare intelligence company serving over 75 health plans—including many of the top 20—and managing data for over 170 million lives. The company uses its AI operating system and domain expertise to untangle complex healthcare data, delivering speed, quality, and accuracy in payment integrity across the healthcare payment continuum.
- • This role offers the opportunity to develop deep expertise in Medicare Secondary Payer regulations, medical claim auditing, COB/TPL processes, and healthcare compliance—skills that are highly valued in the growing healthcare intelligence and payment integrity sectors. Specialists gain experience working with UB-04 and CMS 1500 forms, interpreting EOBs, and navigating complex billing scenarios, positioning them for advancement within Machinify’s expanding operations.
- • The company fosters a culture rooted in core values, diversity, equity, and inclusion, providing reasonable accommodations for qualified individuals with disabilities and committing to equal opportunity employment regardless of race, gender, age, disability, veteran status, or other protected characteristics. Employees are encouraged to uphold confidentiality and data integrity, reporting any violations of sensitive information as part of organizational accountability.
🎯 Requirements
- • Minimum 6 months of medical billing experience, including Medicare, demonstrating depth of knowledge and capability required for the position.
- • Minimum 2 years of experience in customer service, billing reclamation or recovery, or call center role demonstrating application of similar skills.
- • High School diploma or GED is required.
- • Knowledge and experience with medical claim billing procedures, medical terminology and medical coding, preferably in a role generating, auditing, recovery and/or researching the same.
- • Familiarity with information in forms UB04 and CMS 1500.
- • Experience with Coordination of Benefits, Third Party Liability, Medicare Secondary Payer.
🏖️ Benefits
- • Medical, dental, and vision insurance options.
- • Health Savings Account (HSA) and Flexible Spending Account (FSA) options.
- • Life insurance coverage.
- • 401(k) savings plans with potential company match.
- • Family/parental leave and paid holidays.
- • Paid time off (PTO) annually.
Skills & Technologies
Remote
About Performant Corporation
Performant Corporation provides technology-enabled recovery and analytics services to government and commercial clients. It identifies, analyzes, and recovers delinquent or defaulted assets and improper payments in healthcare, student lending, and government revenue programs. The company combines proprietary data matching, statistical modeling, and workflow technology with human expertise to improve recovery rates and reduce costs for payers. Founded in 1976 and headquartered in Livermore, California, Performant serves federal agencies, health insurers, and financial services organizations across the United States.
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