Staff Software Engineer - AI/ML

Staff Software Engineer – AI/ML

5+ years of experience in AI/ML engineering with applied projects in healthcare, RCM, or medical billing
Strong proficiency in Python, SQL, and ML libraries (scikit-learn, XGBoost, TensorFlow/PyTorch, etc.)
Experience with OCR/NLP tools such as Tesseract, AWS Textract, spaCy, or similar
Proven track record building ML pipelines that integrate with backend systems or RPA tools
Deep understanding of revenue cycle metrics: A/R aging, denial codes, CPT/HCPCS/ICD-10, claim statuses
Experience working with EHR, clearinghouse, or payer data (e.g., 837/835 formats, ERA/EOBs)
Strong problem-solving and communication skills with a product and outcome-driven mindset
Understanding of HIPAA and data privacy/security best practices for handling PHI

Develop and deploy AI/ML models for denial prediction, claim prioritization, and payer behavior analysis
Use NLP and computer vision (OCR) to extract structured data from unstructured inputs (e.g., paper faxes, remittance files, EOBs)
Build automated pipelines to monitor open accounts receivable (A/R) and generate exception reports
Support optimization of CPT/ICD-10 coding accuracy using ML classifiers and claim outcome modeling
Collaborate with Billing and RCM teams to identify gaps in collections, trends in denials, and areas for automation
Create dashboards and tools to support reimbursement forecasting, financial performance reporting, and compliance audits
Work with Compliance and Privacy teams to ensure HIPAA-compliant handling of PHI in all data pipelines
Contribute to ongoing automation efforts to improve workflow efficiency across the billing cycle

Experience working with medical billing platforms (Waystar, eClinicalWorks, Epic, Cerner, etc.)
Familiarity with financial forecasting, bad debt analysis, and payer reimbursement models
Background in bioinformatics, digital health, or clinical operations is a plus
M.S. or Ph.D. in Computer Science, Data Science, Biomedical Informatics, or related field