Principal Clinician - Revenue Cycle Management (RCM)

📋 Description

• Own end-to-end clinical revenue cycle quality across AI-powered workflows, including documentation
• Build and operate CDI and coding-accuracy programs, including inter-rater reliability between AI
• Identify coding drift, edge cases, and quality issues; establish timely remediation processes.
• Translate CMS, payer, and industry standards into operational processes (ICD-10, CPT, HCC, CMS
• Lead denial-management strategy with root-cause analysis, CAPA, and closed-loop improvements to AI
• Establish clinical training frameworks; monitor metrics like clean-claim rate, denial rate, and A/R

🎯 Requirements

• 10+ years of progressive clinical experience, with 5+ years in revenue cycle management or related
• Leadership experience overseeing RCM or coding-quality programs at scale.
• Active and unrestricted U.S. RN license or equivalent licensure.
• BSN required; MSN/MHA/MBA/MPH strongly preferred.
• Strong knowledge of ICD-10, CPT, HCC/risk-adjustment coding, CMS utilization-management and
• Familiarity with NCQA, URAC, and HEDIS healthcare quality frameworks.

🎁 Benefits

• Competitive salary aligned with senior-level clinical RCM leadership.
• Medical, dental, and vision coverage.
• Generous vacation policy and company-paid holidays.
• Opportunity to work remotely within the United States.
• High-impact role at the intersection of healthcare, revenue cycle, and AI.
• Exposure to product strategy, engineering, customer success, and leadership.