AI Healthcare Operations

This is a fully remote position, open to applicants in New York.

📋 Description

• Develop realistic scenarios for healthcare operations leveraging professional expertise.

• Assess and analyze AI-generated outputs pertaining to medical coding, billing, claims processing, denials management, prior authorizations, documentation reviews, and revenue cycle operations.

• Evaluate various AI-generated responses to identify the one that aligns best with industry standards and guidelines.

• Create comprehensive evaluation criteria and grading rubrics for healthcare operations workflows.

• Detect errors, omissions, compliance issues, documentation concerns, and workflow deficiencies in AI-generated products.

• Collaborate with project teams to enhance AI training, quality assurance, and data annotation efforts.

• Contribute expert knowledge in healthcare operations to the development and assessment of advanced AI systems.

⛳️ Requirements

• A minimum of 2 years of experience in healthcare operations, including medical coding, billing, clinical documentation integrity, utilization review, claims administration, health information management, or related fields.

• In-depth knowledge of healthcare operations, medical coding, billing, claims management, or revenue cycle processes.

• Experience in interpreting healthcare documentation, payer policies, reimbursement guidelines, and coding standards.

• Exceptional analytical and written communication skills.

• Capability to assess complex information and provide thorough feedback.

• Proficient in using computer systems, data management tools, and cloud-based applications.

• Familiarity with artificial intelligence tools and their applicable uses.

• Experience with ICD-10-CM/PCS coding, CPT and HCPCS coding, revenue cycle management, claims auditing, denials and appeals, prior authorizations, clinical documentation improvement, payer operations, or practice management.

• Professional certifications such as CPC, CCS, RHIA, RHIT, CDIP, or CCDS are preferred but not mandatory.

• Ability to work autonomously, juggle multiple projects, and uphold high-quality standards in a remote setting.

• Strong attention to detail and critical thinking abilities.

• Willingness to learn new processes and adapt to changing project requirements.

• Reliable internet connection and access to a computer.

🏝️ Benefits

• Fully remote work from home.

• Flexible scheduling options.

• Minimum commitment of around 10 hours per week with no maximum limit.

• Potential for full-time hours based on project requirements.

• Independent Contractor role, 13-week DP, without benefits.