RCM AI Compliance Director

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate technical specifications to ensure the AI Platform adheres to existing coding and billing regulations.

• Identify suitable and compliant modeling data while safeguarding patient privacy and billing accuracy.

• Review and authorize recommendations made by AI assistants or agents.

• Establish caveats and boundaries for outputs generated by AI.

• Analyze the RCM regulatory environment, including payer requirements and updates in coding.

• Recognize risks linked to automated workflows.

• Coordinate with Legal, Compliance, and RCM Operations to align on the organization’s AI risk tolerance.

• Maintain documented compliance measures for AI workflows.

• Collaborate with internal audit teams to ensure the platform remains transparent and auditable.

⛳️ Requirements

• Bachelor’s Degree in a relevant field.

• Over 10 years of experience in RCM, healthcare coding, compliance, or billing.

• Direct, hands-on experience in billing and healthcare operations.

• Extensive knowledge of RCM workflows, payer regulations, and compliance risk management.

• Demonstrated experience in implementing compliance programs within high-tech, SaaS, or AI-driven settings.

• Skill in translating ambiguous compliance guidelines into structured technical policies for AI models.

• Capability to act as a stringent compliance gatekeeper and an effective collaborator with technical Product teams.

• Proficiency in converting complex regulatory requirements into actionable guidelines for senior leadership and engineers.

🏝️ Benefits

• Comprehensive medical, dental, and vision coverage.

• Company contribution to Health Savings Account.

• 401(k) matching contribution of 50% on deferrals up to 6% of salary.

• 100% vesting of matching contributions after one year of employment.

• Generous Paid Time Off policy.

• Paid Parental Leave.

• Company-sponsored Life and Disability benefits.

• Flexible Spending Account options.

• Employee Assistance Programs available.

• Company-supported Business Resource & Special Interest Groups.

• Opportunities for professional development.

• Tuition reimbursement programs offered.

• Unlimited access to LinkedIn Learning resources.

• Remote work options for certain positions.