Staff Software Engineer – Revenue Cycle Management

POSITION SUMMARY:

About the Role

We are seeking a Staff Software Engineer with deep expertise in healthcare billing, reimbursement, and revenue cycle systems to develop intelligent tools and automation that support our end-to-end billing operations. This role sits at the intersection of machine learning, healthcare operations, and financial optimization.

You will work closely with our Billing, RCM, Data Engineering, and Compliance teams to identify opportunities for automation, build production-grade models, and deliver ML-powered insights that reduce denials, maximize collections, and improve operational efficiency.

What You’ll Do

• 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 (e.g., paper faxes, remittance files, EOBs)
• 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
• Collaborate with Billing and RCM teams to identify gaps in collections, trends in denials, and areas for automation
• 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

What We’re Looking For

Must-Have Qualifications

• 5+ years of experience in AI engineering with applied projects in healthcare, RCM, or medical billing
• 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
• 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)
• Strong problem-solving and communication skills with a product and outcome-driven mindset
• Excellent communication skills and ability to collaborate with executive leadership
• Understanding of HIPAA and data privacy/security best practices for handling PHI

Preferred Qualifications

• Experience working with medical billing platforms (Waystar, eClinicalWorks, Epic, Cerner, etc.)
• Familiarity with financial forecasting, bad debt analysis, and payer reimbursement models
• Background in bioinformatics, digital health, or clinical operations is a plus
• M.S. or Ph.D. in Computer Science, Data Science, Biomedical Informatics, or related field