Healthcare Subject Matter Expert

We are looking for an experienced Healthcare Subject Matter Expert(SME) to support Contiinex product development bringing US healthcare workflow/process specific knowledge. SME will play a pivotal role in drafting process techniques, defining operational conditions, and ensuring that automation aligns with the real-world workflows of the US healthcare provider and payer contact centers. Ideal candidates are current or former team leaders/Quality auditors from healthcare contact centers, with deep knowledge of all workloads in healthcare operations.

Responsibilities:

• Analyze and document current processes for healthcare provider and payer contact centers, including patient registration, appointment scheduling, billing, claims, and member support.
• Translate operational workflows into automation ready process maps, decision trees, and business rules.
• Draft SOPs, process maps, and quality frameworks and refine process techniques, various application knowledge and operational conditions that will guide the AI automation, ensuring accuracy, compliance, and efficiency.
• Identify and prioritize automation opportunities, focusing on repetitive, rule-based, and high volume tasks suitable for AI agents
• Provide subject matter guidance on healthcare regulations (e.g: HIPAA, CMS), data security, and compliance requirements for automated processes.
• Participate in validation of automated workflows, providing feedback to improve performance and accuracy.
• Serve as the bridge between client and Delivery team to monitor transactions and prepare the ground truth.
• Continuously monitor and analyze performance metrics, identifying areas for further automation or process improvement.

Requirements

Experience: 6-8years(Core Healthcare Operations)

• Past experience as a team leader or Quality auditor in a healthcare provider or payer contact center
• In-depth understanding of healthcare contact center operations, including patient/member interactions, appointment management, billing, claims, AR and compliance
• Strong analytical and process mapping skills, with the ability to translate complex workflows into clear, usable process flows
• Familiarity and data knowledge with all applications used; Understanding of AI based automation, or conversational AI platforms is good to have
• Knowledge of healthcare regulations and data privacy requirements
• Excellent communication skills, with the ability to collaborate across technical and operational teams

Benefits

You will be part the team that is making healthcare transformation with Speech AI technology, helping to shape how it can automate workloads and enhance patient and member experiences in a evolving healthcare industry.