Senior AI Software Engineer - Medicare Billing and Care Management Platforms
ChronicCareIQ · Alpharetta, GA · 3 wk ago
HybridEngineeringFull-time
Primary Responsibilities
- Design and develop software solutions supporting: CCM (99490, 99439, 99491), RPM (99453, 99454, 99457, 99458), RTM (98975, 98976, 98977, 98980, 98981), PCM (99424–99427), Behavioral Health Integration (BHI), Transitional Care Management (TCM), Annual Wellness Visits (AWV)
- Implement CMS billing rules, reimbursement logic, eligibility validation, and audit controls
- Develop time-tracking and documentation workflows to support compliant billing
- Build claim generation and billing reconciliation capabilities
- Collaborate with operations teams to improve billing accuracy and reduce revenue leakage
- Design scalable microservices and APIs supporting patient management, billing, and reporting workflows
- Develop dashboards for care managers, providers, billing teams, and administrators
- Implement workflow automation for enrollment, consent management, care plan generation, and patient outreach
- Develop integrations with EHR systems such as: Epic Systems, athenahealth, AdvancedMD, eClinicalWorks, NextGen Healthcare
- Ensure data synchronization, patient matching, and interoperability compliance
Requirements
- Strong experience with C#, NET Core / ASP.NET Core, REST APIs, SQL Server or MySQL
- Experience with AI coding tools: Augment Code, Cursor, Claude Code, GitHub Copilot
- Experience with Azure or AWS cloud platforms, microservices architecture, event-driven systems, CI/CD pipelines, Docker and Kubernetes
- Experience with FHIR APIs, HL7 v2, Healthcare interoperability standards, EHR integration architecture
- Unit testing and integration testing, automated testing frameworks, Git-based development workflows
Qualifications
- 8+ years of software engineering experience
- 4+ years building healthcare SaaS applications
- Strong understanding of Medicare care management programs: CCM, RPM, RTM, PCM, BHI
- Experience implementing CPT code-based billing workflows
- Knowledge of CMS reimbursement policies and healthcare revenue cycle management
- Experience with Azure AI, OpenAI, or healthcare analytics platforms