AI Trainer - Healthcare Operations

Planet Pharma; Chicago (IL); Vor Ort; AUD 85.000 - 120.000; Vollzeit

Zusammenfassung

Planet Pharma is seeking a healthcare operations expert to assess AI-generated outputs across coding, billing, claims, CDI, and utilization management. Use real-world experience to help AI navigate complex healthcare workflows and regulatory requirements.

You will create realistic scenarios, evaluate AI results, and provide detailed feedback to improve coding accuracy, payer rules, documentation and reimbursement processes across multiple jurisdictions.

Qualifikationen

• Minimum 2+ years in medical coding, billing, or related revenue cycle roles.
• Strong knowledge of healthcare workflows and regulatory requirements.
• Familiarity with ICD-10, CPT, HCPCS, DRG, APC and payer policies.

Aufgaben

• Create realistic healthcare operations scenarios from experience.
• Evaluate AI-generated coding, claims, CDI, and utilization outputs.
• Identify errors, risks, and compliance gaps in AI results.
• Develop scoring criteria and evaluation frameworks.
• Provide detailed feedback on coding accuracy and reimbursement processes.

Kenntnisse

Medical coding expertise

Healthcare workflow knowledge

ICD-10 CPT HCPCS DRG APC policies

Ausbildung

CPC, CCS, CCA, RHIA, RHIT, CDIP, CCDS certifications

Jobbeschreibung

Use your real-world healthcare operations experience to assess AI-generated work across coding, billing, claims, prior authorizations, denials, audits, and clinical documentation. You'll help improve AI's ability to accurately navigate complex healthcare workflows and regulatory requirements.

Responsibilities

• Create realistic healthcare operations scenarios based on professional experience
• Evaluate AI-generated coding, claims, audit, CDI, and utilization management outputs
• Compare AI responses and identify errors, risks, and compliance gaps
• Develop scoring criteria and quality evaluation frameworks
• Provide detailed feedback on coding accuracy, payer rules, documentation, and reimbursement processes

Requirements

• 2+ years of experience in Medical Coding, Billing, Revenue Cycle, HIM, CDI, Utilization Review, Case Management, or Payer Operations
• Strong knowledge of healthcare workflows and compliance requirements
• Familiarity with coding systems such as ICD-10, CPT, HCPCS, DRG, APC, and payer policies

Preferred Backgrounds

• Medical Coding & Auditing
• Clinical Documentation Integrity (CDI)
• Denials & Appeals Management
• Revenue Cycle Operations
• Health Information Management (HIM)
• Claims Processing & Payer Operations
• CPC, CCS, CCA, RHIA, RHIT, CDIP, or CCDS certifications
• Familiarity with AI tools and large language models (LLMs)

Planet Pharma is an American parented Employment Business/Agency that provides global staffing services with its headquarters in Chicago and our EMEA regional office located in Central London. We have invested significantly in creating a robust international platform that enables us to work compliantly in 30+ countries with a current network of 2500+ active contractors globally as well as a very strong permanent / direct hire recruitment offering.

Our specialist knowledge and close relationships with our clients and the wider industry really makes us unique in our field. Just recently we were recognized by FORBES as the 17th best professional staffing firm and have won multiple awards from industry accredited bodies for our commitment to excellence and service delivery. We have extensive functional expertise including Regulatory Affairs, Pharmacovigilance, QA, QC, Submissions experts, Clinical development, Quality, Biostatistics, and Medical Affairs / Writing.

We are an equal opportunities Recruitment Business and Agency. We welcome applications from all suitably qualified candidates regardless of their race, sex, disability, religion/belief, sexual orientation or age.

www.planet-pharma.com