Subject Matter Expert, Revenue Cycle

Translucent

$175K — $250K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 7+ years in provider revenue cycle or patient financial services
  • Expertise in denials, underpayment recovery, and charge capture
  • Strong knowledge of revenue cycle systems like Epic Resolute or Cerner
  • Ability to convert workflows into data and logic for algorithms
  • Excellent communication with various stakeholders
  • Capacity to define success criteria in ambiguous scenarios
  • Intellectual curiosity about revenue cycle and AI applications
  • Hands-on willingness to engage in detailed analyst tasks

Responsibilities

  • Develop subject matter expertise to support AI in revenue cycles
  • Collaborate with engineering, product, and design to build AI systems
  • Create benchmarks and datasets to evaluate AI models
  • Identify customer pain points in revenue cycle operations
  • Translate financial requirements into technical solutions

Benefits

  • Flexible work arrangements
  • Opportunities for professional development
  • Collaborative team environment
  • Potential for equity participation
  • Access to cutting-edge technology and AI tools
Full Job Description
ROLE DETAILS
  • Full-Time
  • Office Location - New York City (preferred)
ROLE OVERVIEW

Revenue cycle is where healthcare's most auditable margin leakage lives, and where the distance between a flagged variance and a recovered dollar is operator judgment. As our subject matter expert for this domain, you will bring that judgment into the product itself, shaping how our agents reason about denials, underpayments, and charge capture, defining what a correct answer looks like, while holding model output to the standard a working revenue cycle leader would apply.
WHAT YOU'LL DO

To facilitate the development of these systems, you will:
  • Develop and deliver subject matter expertise in healthcare revenue cycle to support AI product development and customer margin realization
  • Work closely with our engineering, product, and design teams to define and develop AI systems for revenue cycle workflows
  • Build proprietary benchmarks and datasets to evaluate models and AI agents against real-world revenue cycle tasks including, but not limited to: denial root-cause classification, underpayment detection, expected-versus-paid reconciliation, charge capture review and prior-authorization triage
  • Partner with customer delivery to understand our customer's revenue cycle operations, identify pain points, and translate complex financial and operational requirements into technical solutions
WHAT YOU HAVE
  • 7+ years in provider revenue cycle, patient financial services, or an equivalent function, ideally with exposure to denials, underpayment recovery, charge capture, and payor compliance
  • Ability to convert workflows and hypotheses into structured data, rules, and logic for algorithms and quality measurement as well as the expertise to link data points that may not already speak to each other in ways that enhance performance
  • Strong proficiency with revenue cycle systems and the data underneath them (Epic Resolute, Cerner/Oracle Health, or similar), plus fluency in 835/837 transactions, claim adjustment reason codes, and appeal construction
  • Demonstrated ability to deliver high-quality analyses on demanding deadlines
  • Ability to effectively communicate with a variety of internal and external stakeholders and translate complex problems between revenue cycle, product, and engineering teams
  • Ability to define positive outcomes in situations with underspecified success criteria
  • Deep intellectual curiosity and eagerness to learn across domains, particularly at the intersection of revenue cycle and AI
  • Willingness and desire to do work in the trenches - e.g., grading hundreds of model-generated denial classifications, hand-adjudicating flagged accounts to establish ground truth, stress-testing outputs against how a real appeal would actually land. Getting AI to do analyst-level revenue cycle work requires a lot of things that look like analyst-level revenue cycle work
NICE TO HAVE
  • Experience at a high-growth startup
  • Familiarity with SQL, Python, or other data tools
  • Prior exposure to AI/ML concepts or prompt engineering


Anticipated compensation: $175,000 - $250,000 and Equity

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