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About the role
Roles and Responsibilities Product Strategy & Architecture - Define core functional requirements for EHR and RCM software modules. - Design workflows for patient scheduling, clinical charting, and e-prescribing. - Architect end-to-end medical billing workflows from charge capture to clearinghouses. - Guide engineering teams on claim scrubbing, ERA/835 processing, and denial management. - Testing of workflows, modules and screens and hands-on with test cases. Compliance & Interoperability - Ensure product compliance with HIPAA, MIPS, MACRA, and Meaningful Use/Promoting Interoperability. - Direct the integration of HL7, FHIR, and EDI X12 transaction standards (e.g., 270/271, 837P/I, 835). - Maintain up-to-date system knowledge of ICD-10, CPT, HCPCS, and LOINC codes. Cross-Functional Leadership - Translate complex US healthcare regulations into clear technical user stories. - Validate software builds through rigorous clinical and financial scenario testing. - Act as the primary consultant for development, product, and client on boarding teams. - Desired Candidate Profile - Any Degree / PG with Allied / Health Life Sciences, BSMS, BAMS - Minimum 5 to 7 years of experience in US healthcare software development or product management. - Deep technical knowledge of ambulatory or inpatient EHR workflows. - Hands-on expertise with the institutional and professional medical billing cycles. - Proven track record handling EDI clearinghouse integration's and ANSI X12 standards. Skills & Knowledge - Strong understanding of value-based care models and payer reimbursement rules. - Ability to map complex data environments and database structures for healthcare analytics. - Excellent communication skills to explain healthcare compliance to software engineers. - Exposure to EHR platforms like Epic, Cerner, Dr.Chrono, eClinicalWorks etc would be well desired. Preferred Certifications - Certified Professional Biller (CPB) or Certified Skilled Coder (CPC). - Certified Coding Specialist (CCS) .
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