AI/ML Development Leadership: Lead the implementation of machine learning models and automation pipelines for CPT/ICD code prediction and claims processing. Develop and optimize retrieval-augmented generation (RAG) workflows using LLMs, vector databases (e.g., FAISS), and custom prompts. Direct the design of structured training datasets derived from SOAP notes, payer files, and denial records. Team & Project Management: Manage day-to-day activities of India-based engineers and coding specialists. Coordinate closely with U.S.-based consultants to ensure AI solutions align with reimbursement policy and documentation standards. Track project milestones, guide model improvements, and ensure output quality. Technical Execution: Build, fine-tune, and deploy models using PyTorch, TensorFlow, HuggingFace Transformers , and scikit-learn . Integrate LLM APIs for code summarization and document understanding. Implement vector search and orchestration platforms for real-time AI assistance. Role & responsibilities Preferred candidate profile
Role & responsibilities Audit and validate AI-generated CPT/ICD coding outputs for accuracy, completeness, and alignment with payer guidelines. Provide subject matter expertise to the ML development team, helping explain documentation requirements, billing logic, and workflow detailsparticularly within the Athena EHR platform. Identify edge cases and guide the creation of test cases and labeled datasets for model improvement. Perform quality assurance reviews and root-cause analysis of audit errors, offering structured feedback for continuous learning. Lead knowledge-sharing efforts across teams and support documentation of best practices. Preferred candidate profile
Role & responsibilities Design, develop, and maintain interactive dashboards and reports in Tableau . Perform ad hoc reporting and in-depth trend analysis for clinical and operational metrics. Write and optimize SQL queries for data extraction, transformation, and analysis within Snowflake . Interpret healthcare claims, coding, and provider performance data, with a focus on CPT, ICD-10, RVUs, and other key healthcare indicators. Collaborate with US-based stakeholders to understand business requirements and deliver accurate, timely reports. Ensure data integrity, accuracy, and compliance with HIPAA and applicable data privacy standards. Company website: https://www.olleyahealth.com
Role & responsibilities Audit and validate AI-generated CPT/ICD coding outputs for accuracy, completeness, and alignment with payer guidelines. Provide subject matter expertise to the ML development team, helping explain documentation requirements, billing logic, and workflow detailsparticularly within the Athena EHR platform. Identify edge cases and guide the creation of test cases and labeled datasets for model improvement. Perform quality assurance reviews and root-cause analysis of audit errors, offering structured feedback for continuous learning. Lead knowledge-sharing efforts across teams and support documentation of best practices. Preferred candidate profile
Director of Denials and A/R Follow-Up Athena Health Platform Company: OlleyaHealth Pvt Ltd Website: https://www.olleyahealth.com/ Location: Remote (India) Position Type: Full-time, Permanent Reports to: Vice President of Revenue Cycle Operations Compensation: Competitive, commensurate with experience About OlleyaHealth OlleyaHealth provides end-to-end revenue cycle management, medical billing, and automation solutions to U.S.-based healthcare providers. Our teams specialize in Athena Health workflows and bring efficiency and precision to multi-specialty physician groups. We are expanding our leadership team and seeking a Director of Denials and A/R Follow-Up to oversee denial management, payer communication, and collections operations within the Athena ecosystem. Role Summary The Director of Denials and A/R Follow-Up will lead all functions related to insurance denials, appeals, and accounts receivable recovery for Athena Health-based clients. This role requires strong technical expertise, leadership, and the ability to improve denial outcomes and revenue performance through optimized workflows and team management. Key Responsibilities Direct all denial management and A/R follow-up activities for Athena Health clients. Create SOPs for denial categorization, appeals, and escalation workflows aligned to Athena capabilities. Manage large teams of A/R specialists and ensure timely resolution of claims. Identify and address root causes of denials through cross-functional collaboration with coding and billing teams. Oversee payer correspondence, EOB/ERA processing, and aging analysis. Develop KPI dashboards tracking DSO, recovery rate, and denial overturn percentage. Collaborate with automation and analytics teams to implement AI and RPA tools for queue prioritization. Maintain full HIPAA and payer compliance across all operations. Qualifications Minimum 8 years of experience in U.S. medical billing, denials, and A/R , including 5+ years of hands-on Athena Health experience in a multi-specialty practice environment. Proven success leading large denial management or A/R teams. Expert understanding of payer rules, denial codes, appeals, and resolution workflows. Strong familiarity with Athena reports, claim status queues, and reconciliation tools. Excellent communication and leadership skills. Bachelor’s degree in healthcare administration, business, or related field preferred.
Company: OlleyaHealth Pvt Ltd Website : https://www.olleyahealth.com/ Location: Remote (India) Position Type: Full-time, Permanent Reports to: Vice President of Revenue Cycle Operations Compensation: Competitive, commensurate with experience About OlleyaHealth OlleyaHealth is a rapidly growing healthcare operations and technology company supporting U.S.-based physician groups and hospitals in revenue cycle management, coding, and automation. Our teams deliver end-to-end medical billing and AI-enabled solutions for clients across multiple specialties. We are seeking an experienced Director of Coding with deep knowledge of Athena Health (AthenaOne) to lead our coding division and drive accuracy, compliance, and operational excellence. Role Summary The Director of Coding will oversee all professional coding operations for U.S. physician groups using the Athena Health platform. This leader will design coding processes, supervise coding teams, maintain compliance standards, and collaborate with automation and analytics teams to achieve the highest levels of accuracy and financial performance. Key Responsibilities Direct and manage the coding operations for Athena Health clients across multiple specialties. Develop SOPs for CPT, ICD-10, and modifier usage consistent with Athena workflows and payer requirements. Lead, mentor, and evaluate coding teams to ensure productivity and accuracy standards are met. Oversee coding quality audits and compliance reviews; implement corrective actions and retraining plans. Collaborate with provider clients on documentation improvement, HCC risk coding, and education. Partner with analytics teams to identify patterns in denials and improve documentation accuracy. Track and report KPIs including accuracy rate, turnaround time, and clean claim percentage. Maintain HIPAA and CMS compliance across all operations. Qualifications Minimum 8 years of professional medical coding experience , including 5+ years working with Athena Health workflows in a multi-specialty practice environment. Proven leadership experience managing teams of 20 or more coders. Certified Professional Coder (CPC, CCS-P, or equivalent) required. Advanced knowledge of coding compliance, payer rules, and U.S. reimbursement methodologies. Excellent leadership, analytical, and communication skills. Bachelors degree in healthcare, business, or related field preferred. Role & responsibilities