About this role
Apply medical billing and claims leadership to evaluate AI-generated workflows that support more accurate claims submission, stronger first-pass acceptance, and faster revenue cycle performance.
Key Responsibilities- Lead end-to-end medical billing and claims submission operations in professional fee and/or facility billing environments.
- Review AI-generated billing outputs, claim edits, and coding validations for accuracy and payer compliance.
- Manage electronic claim generation, clearinghouse edits, and payer-specific billing requirements.
- Track clean claim, rejection, and first-pass acceptance rates, then develop improvement strategies.
- Partner with coding, CDI, and collections teams to resolve billing edits and claim rejections.
- Maintain compliance with CMS billing guidance, HIPAA 837 transaction standards, and payer billing rules.
- Manage billing-team workloads, productivity, and quality metrics.
- Create and maintain billing SOPs and payer-specific reference guides.
- Annotate AI outputs and provide structured feedback for AI training datasets.
- At least 5 years of medical billing and claims-management experience, including 2 or more years in a management role.
- Deep knowledge of professional fee billing, CMS-1500/837P, and/or facility billing, UB-04/837I.
- Expertise in HIPAA 837 transactions, clearinghouse operations, payer-specific rules, and Medicare, Medicaid, and commercial-payer billing requirements.
- Experience with Epic, Athenahealth, AdvancedMD, or comparable billing platforms, plus clearinghouse tools.
- Excellent written and verbal English communication skills.
- Strong attention to detail and the ability to identify billing errors and compliance issues in AI-generated outputs.
- CPC, CCS, CHFP, or CRCR certification.
- Experience with automated billing platforms or revenue cycle management technology implementations.
- Experience in multi-specialty physician group, hospital, or health system billing operations.
- Comfort using AI tools and evaluating AI-generated billing content.
- Experience interpreting payer contracts or managing billing compliance programs.
- Remote, hourly engagement.
- $80 per hour.
Contribute to high-impact healthcare AI work alongside an advanced AI research organization, with exposure to emerging billing and revenue cycle workflows.