01Key Responsibilities
Design and implement AI/ML models for claims prioritization, denial resolution, and revenue cycle optimization.
Develop and fine-tune LLMs and SLMs to enhance automation in claims management workflows. Preprocess and structure claims data for effective model training.
Deploy, manage, and scale AI models using Azure-based cloud services.
Continuously monitor model performance, retrain, and refine algorithms to improve accuracy and operational efficiency.
Ensure compliance with HIPAA, PHI security standards, and healthcare data privacy regulations.
Document technical solutions and create best practices for scalable AI-driven claims management.
Qualifications:
Bachelor's or master's degree in computer science, AI/ML, Engineering, or a related field.
3+ years of experience in AI/ML engineering, preferably in healthcare claims automation.
Proficiency in Python, with strong knowledge of LLMs, NLP, and text analytics for claims processing.
Experience with Azure ML services for deploying machine learning models.
Familiarity with healthcare claims data formats (EDI 837/835) and revenue cycle processes.
Strong analytical, problem-solving, and teamwork skills.
Preferred Skills:
Experience with AI-driven denial resolution and automated claims adjudication.
Understanding of EHR/EMR systems and insurance reimbursement processes.
Familiarity with DevOps, CI/CD pipelines, and MLOps for scalable AI deployments.
What We Offer:
Competitive salary and advantages package.
Opportunity to contribute to cutting-edge AI solutions in the healthcare industry.
Dynamic and collaborative work environment.
Opportunities for continuous learning and professional growth.
Compensation: Up to 1,000,000.00 per year
Advantages:
Health insurance
Paid sick ti .
