Al Solution Architect - Heathcare RCM Automation

Job Description

Our client seeking an experienced Al Solution Architect to design and implement HIPAA-compliant Al and Agentic solutions that transform healthcare Revenue Cycle Management (RCM) operations

Key Responsibilities

• Assess end-to-end RCM workflows (Patient Access, Coding, Charge Capture, Claims, Denials, Payments, AR, Correspondence) and identify automation opportunities.
• Design Al-enabled and Agentic workflow solutions using HIPAA-compliant components and architectures.
• Create solution blueprints, process flows, business cases, and implementation roadmaps.
• Build and deploy Al agents and multi-agent workflows to solve real-world operational problems.
• Integrate Al solutions with EHR, PM, clearinghouse, RPA, document management, and communication platforms.
• Define governance frameworks covering security, privacy, auditability, human-in-the-loop controls, and compliance requirements.
• Collaborate with Operations, Product, Engineering, Compliance, and Client stakeholders to deliver scalable solutions.
• Measure and continuously optimize automation outcomes using operational KPIs and ROI metrics.

Preferred Qualifications

• Exposure to cloud platforms such as AWS, Azure, or Google Cloud healthcare environments.
• Familiarity with healthcare interoperability standards and RCM technologies.
• Understanding around automating coding, claims scrubbing, denial management, payment posting, AR follow-up, or document processing workflows.

Required Qualifications

• 6+ years of experience in Information Technology space. 3+ years of experience in U.S. Healthcare Revenue Cycle Management.
• 2+ years of hands-on experience designing and deploying Al, Agentic Al, or Al Agent solutions in production environments.
• Understanding of RCM workflows, payer rules, and operational pain points.
• Experience with LLMs, orchestration frameworks, prompt engineering, retrieval architectures, and agent frameworks.
• Practical experience integrating Al solutions using APIs and cloud platforms.
• Knowledge of HIPAA requirements, PHI handling, security controls, and responsible Al practices.
• Ability to translate business requirements into technical solution designs and executive-level recommendations.

Success Measures

• Reduction in manual effort and turnaround times.
• Increased productivity and automation adoption.
• Improved quality and accuracy outcomes.
• Demonstrated ROI from deployed Al solutions.
• Delivery of secure, compliant, and scalable automation capabilities.

Work Details

• Work Shift: (SL/IST TIME) Straddle 3:00 PM - 12:00 PM
• Work Week: Monday to Friday