AI Solutions Engineer

We are seeking an innovative RCM AI Solutions Engineer to lead the development and implementation of AI-powered solutions that transform revenue cycle operations. This individual will identify automation opportunities, design intelligent workflows, and deploy AI-driven tools that improve efficiency, accuracy, and decision-making across the revenue cycle lifecycle.

What You'll Do:

AI Solutions Development

• Design, build, test, and deploy AI-powered tools, agents, and workflows.
• Develop custom prompts and automation solutions that streamline operational processes.
• Integrate AI solutions with healthcare and business systems.
• Evaluate new AI capabilities and recommend innovative applications.

Revenue Cycle Optimization

• Identify opportunities to automate manual tasks and reduce administrative burden.
• Improve workflows related to:
• Prior Authorizations
• Denial Management
• Claims Follow-Up
• Eligibility & Benefits Verification
• Revenue Cycle Operations
• Measure and monitor performance improvements resulting from AI adoption.

Cross-Functional Collaboration

• Partner with operational, technology, compliance, finance, and clinical teams to deliver effective solutions.
• Serve as a subject matter expert on AI tools and best practices.
• Train end users and support organizational adoption of AI-powered workflows.

Governance & Compliance

• Ensure adherence to healthcare regulatory requirements, privacy standards, and responsible AI practices.
• Implement monitoring, quality assurance, and governance processes for AI solutions.
• Maintain documentation and support ongoing optimization efforts.

Qualifications:

• 3 years of experience in Healthcare Revenue Cycle Management (RCM).
• Knowledge of claims processing, denials, authorizations, eligibility verification, and billing operations.
• Experience with AI, automation, machine learning, conversational AI, or workflow optimization technologies.
• Familiarity with large language models (LLMs), prompt engineering, and AI-powered business applications.
• Experience integrating solutions with enterprise software platforms.
• Understanding of healthcare compliance, privacy, and data security requirements.
• Strong analytical, problem-solving, and communication skills.
• Ability to collaborate across technical and operational teams while driving change and innovation.