Revenue Integrity Specialist for AI Evaluation

Lead evaluation of AI tools that detect revenue leakage, improve charge accuracy, and support coding and billing compliance. This role applies deep practical experience in charge capture, CDM management, and revenue integrity analysis to validate AI outputs, audit charge workflows, and help shape AI training data that will improve revenue performance and reduce compliance risk for a leading AI research lab.

• Oversee charge capture, charge integrity, and revenue integrity activities to ensure charges are submitted accurately and in compliance with payer and regulatory requirements.
• Evaluate AI-generated charge review results, coding suggestions, and revenue integrity alerts for accuracy, completeness, and compliance.
• Perform charge audits to identify missed charges, duplicate charges, and other charge capture errors across clinical departments.
• Manage and maintain the charge description master, ensuring charge codes, revenue codes, and pricing are correct and up to date.
• Analyze charge patterns to identify revenue leakage opportunities and develop corrective action plans.
• Collaborate with clinical, coding, and billing teams to resolve charge capture discrepancies and implement process improvements.
• Monitor key performance indicators, including charge lag times, charge capture accuracy rates, and revenue integrity findings.
• Ensure adherence to CMS billing guidelines, Medicare Part A and Part B billing rules, OIG work plan priorities, and payer-specific requirements.
• Annotate AI outputs and provide structured, high-quality feedback to support creation of training datasets and continuous improvement of AI models.

• Minimum 5 years of experience in charge capture, charge integrity, revenue integrity, or healthcare compliance.
• Deep knowledge of charge capture workflows, charge description master management, revenue codes, and billing compliance.
• Strong understanding of CMS billing guidelines, Medicare Part A and Part B rules, and OIG compliance expectations.
• Proficiency with charge capture systems, electronic health record platforms, and revenue integrity tools.
• Proven experience conducting charge audits and developing corrective action plans.
• Exceptional written and verbal English communication skills.
• High attention to detail, with the ability to identify billing errors and compliance risks in AI-generated outputs.

• Credentials such as CPC, CCS, CHFP, or CRCS.
• Experience with 340B drug program charge capture and compliance.
• Background working in hospital, health system, or physician group revenue integrity operations.
• Familiarity with AI tools, and comfort evaluating AI-generated charge and billing content.
• Experience with revenue integrity software platforms and analytics tools.

• Location, Remote.
• Employment type, hourly.

• $88 per hour.

• Contribute to development of frontier AI systems focused on healthcare revenue integrity.
• Collaborate with a leading AI research organization and multidisciplinary teams.
• Gain exposure to cutting-edge AI workflows and influence high-impact projects that shape the future of healthcare billing and compliance.