Develop intelligent tools and automation to support end-to-end billing operations in healthcare billing, reimbursement, and revenue cycle systems.
Requirements
- Strong proficiency in Python, SQL, and ML libraries (scikit-learn, XGBoost, TensorFlow/PyTorch, etc.)
- Experience with OCR/NLP tools such as Tesseract, AWS Textract, spaCy, or similar
- Proven track record building ML pipelines that integrate with backend systems or RPA tools
- Deep understanding of revenue cycle metrics: A/R aging, denial codes, CPT/HCPCS/ICD-10, claim statuses
- Experience working with EHR, clearinghouse, or payer data (e.g., 837/835 formats, ERA/EOBs)
- Experience working with medical billing platforms (Waystar, eClinicalWorks, Epic, Cerner, etc.)
- Familiarity with financial forecasting, bad debt analysis, and payer reimbursement models
Responsibilities
- Develop and deploy AI/ML models for denial prediction, claim prioritization, and payer behavior analysis
- Use NLP and computer vision (OCR) to extract structured data from unstructured inputs
- Build automated pipelines to monitor open accounts receivable (A/R) and generate exception reports
- Support optimization of CPT/ICD-10 coding accuracy using ML classifiers and claim outcome modeling
- Create dashboards and tools to support reimbursement forecasting, financial performance reporting, and compliance audits
- Work with Compliance and Privacy teams to ensure HIPAA-compliant handling of PHI in all data pipelines
- Contribute to ongoing automation efforts to improve workflow efficiency across the billing cycle
Other
- 5+ years of experience in AI/ML engineering with applied projects in healthcare, RCM, or medical billing
- Strong problem-solving and communication skills with a product and outcome-driven mindset
- Understanding of HIPAA and data privacy/security best practices for handling PHI
- M.S. or Ph.D. in Computer Science, Data Science, Biomedical Informatics, or related field
- Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
