Remote Position
[Remote] Revenue Cycle Automation Consultant / SME
🌍 Remote · Spain
💼 Full-time
Note: The job is a remote job and is open to candidates in USA. Valene Health is hiring a Revenue Cycle Automation Consultant / Subject Matter Expert to translate healthcare revenue cycle operations into scalable, technology-driven solutions. The role partners with product and engineering teams to define requirements, design workflows, and guide AI-powered healthcare automation development.
Responsibilities
- Translate complex RCM processes into actionable product requirements, workflow diagrams, business rules, and technical specifications
- Provide subject matter expertise across insurance eligibility, benefits verification, prior authorization, claims processing, and denial management
- Identify automation opportunities, operational dependencies, exception scenarios, and human-in-the-loop requirements
- Define data inputs/outputs, integration requirements, and system interactions across EHRs, practice management systems, clearinghouses, and payer platforms
- Collaborate closely with engineers to validate solution designs, review implementation decisions, and support testing
- Help prioritize capabilities based on operational feasibility, scalability, and measurable business impact
Skills
- 7+ years of experience in healthcare revenue cycle operations, RCM technology, or healthcare automation
- Demonstrated hands-on understanding of eligibility verification, benefits verification, prior authorization, claims workflows, and denial management
- Experience designing, implementing, or optimizing RCM technology solutions, not solely performing administrative RCM functions
- Direct experience working with EHRs, practice management systems, clearinghouses, or payer connectivity platforms
- Ability to translate operational workflows into structured product requirements, business logic, and engineering-ready specifications
- Experience collaborating with software engineering, product, or healthcare IT teams
- We're looking for someone with practical revenue cycle expertise who has also helped design, implement, or improve healthcare technology solutions
- Previous experience at an RCM technology vendor, healthcare automation company, clearinghouse, or healthcare IT organization
- Experience building or implementing provider-facing RCM software products
- Familiarity with healthcare interoperability, APIs, and EDI/X12 transactions (270/271, 278, 837, 835, 276/277)
- Experience with platforms such as Epic, athenahealth, Oracle Health, Availity, or similar systems
- Exposure to AI-driven automation, workflow orchestration, or intelligent process automation
- Experience supporting specialty practices, ambulatory care organizations, or multispecialty medical groups
Company Overview