AI Solution Architect

Role & responsibilities:

• Assess end-to-end RCM workflows (Patient Access, Coding, Charge Capture, Claims, Denials, Payments, AR, Correspondence) and identify automation opportunities.
• Design AI-enabled and Agentic workflow solutions using HIPAA-compliant components and architectures.
• Create solution blueprints, process flows, business cases, and implementation roadmaps.
• Build and deploy AI agents and multi-agent workflows to solve real-world operational problems.
• Integrate AI 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.

Qualifications:

• Bachelor's degree in Computer Science, Engineering, or Mathematics.
• 6+ Years of experience in Information Technology space.
• 2+ years of experience in U.S. Healthcare Revenue Cycle Management.
• 2+ years of hands-on experience designing and deploying AI, Agentic AI, or AI 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 AI solutions using APIs and cloud platforms.
• Knowledge of HIPAA requirements, PHI handling, security controls, and responsible AI practices.
• Ability to translate business requirements into technical solution designs and executive-level recommendations.
• 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.