Associate Director Solutions REF108323CHealthcare

Role: Revenue Cycle Management (RCM) Product Consulting

Position Summary: We are looking for a highly skilled professional to join as a Techno-Functional Expert in the field of RCM. This role will serve as a critical bridge between business stakeholders domain experts and technology teams and will contribute to the development of a next-generation RCM platform integrating outcome-driven automation and AI-powered capabilities including but not limited to claims automation autonomous coding collections analytics and denials management. The ideal candidate brings deep field-level knowledge of revenue cycle workflows and is adept at translating operational pain points into technical requirements for innovative scalable solutions.

Key Responsibilities

Business Analysis & Requirements Gathering

Engage with RCM stakeholders (operations compliance technology) to gather and document detailed business requirements across intake coding billing claims A/R and denials.

Define user stories business rules data flows and system behavior aligned with operational outcomes.

Work closely with product managers to prioritize features based on business value and technical feasibility.

Partner with sales and account teams to shape solutions for new opportunities contributing to solution design proposals due diligence and client presentations.

Subject Matter Expertise (SME)

Provide domain expertise in U.S. healthcare revenue cycle processes and technologies.

Offer field-level insights from front-end intake through back-end collections and appeals.

Advise on industry best practices compliance considerations and emerging trends in automation and AI adoption in RCM.

Techno-Functional Collaboration

Act as a liaison between business users and development teams to ensure solution design aligns with functional needs.

Partner with architects and engineers on data modeling workflow engines and AI/ML model integration.

Participate in user acceptance testing (UAT) validating system outputs against business expectations.

Platform Innovation

Contribute to platform design and modularization of features such as (but not limited to)

o Claims Automation (e.g. OCR NLP intelligent form capture)

o Autonomous Coding (ICD/CPT code prediction using AI/ML)

o Process Optimization (clearinghouse logic eligibility validation)

o Denials Prevention & Prediction (ML-based denial scoring root cause analytics)

Identify opportunities for AI/automation to enhance accuracy reduce TAT and minimize human intervention.

Documentation & Change Management

Develop clear documentation including BRDs FRDs process maps and data dictionaries.

Support training change management and knowledge transfer to internal teams and client stakeholders.

Qualifications :

Bachelors BCA

Remote Work :

No

Employment Type :

Full-time