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Jobs · Information Technology · Georgia

Senior AI Software Engineer - Medicare Billing and Care Management Platforms

Discharge IQ, Inc. · Alpharetta, GA · 2 wk ago
HybridInformation TechnologyFull-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.

    Healthcare Platform Development

    • Design scalable microservices and APIs supporting patient management, billing, and reporting workflows.
    • Build patient risk stratification and population health management capabilities.
    • Develop dashboards for care managers, providers, billing teams, and administrators.
    • Implement workflow automation for enrollment, consent management, care plan generation, and patient outreach.

    EHR and Healthcare Integrations

    • Develop integrations with EHR systems such as:
      • Epic Systems
      • athenahealth
      • AdvancedMD
      • eClinicalWorks
      • NextGen Healthcare
      • Build interfaces utilizing:
        • HL7
        • FHIR APIs
        • CCD/C-CDA
        • Ensure data synchronization, patient matching, and interoperability compliance.

        Security & Compliance

        • Develop solutions compliant with:
          • HIPAA
          • CMS requirements
          • SOC 2 controls
          • HITRUST frameworks
          • Implement secure coding practices, audit logging, encryption, and access controls.

          Technical Leadership

          • Mentor engineers and participate in architecture reviews.
          • Drive engineering best practices, code quality, testing automation, and DevOps maturity.
          • Participate in technical roadmap planning and platform modernization initiatives.
          • Collaborate with Product and Operations teams to translate regulatory requirements into software capabilities.

          Required Qualifications

          • Healthcare Domain Experience
          • 8 plus years of software engineering experience.
          • 4 plus years building healthcare SaaS applications.
          • Strong understanding of Medicare care management programs:
            • CCM
            • RPM
            • RTM
            • PCM
            • TCM
            • BHI
          • Experience implementing CPT code-based billing workflows.
          • Knowledge of CMS reimbursement policies and healthcare revenue cycle management.

          Technical Skills

          • Strong experience with:
            • C#
            • .NET Core / ASP.NET Core
            • REST APIs
            • SQL Server or MySQL
            • One of 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:
                • Entity Framework
                • Message queues
                • Distributed systems
                • Integration Experience
                  • FHIR APIs
                  • HL7 v2
                  • Healthcare interoperability standards
                  • EHR integration architecture
                • Quality & Delivery
                  • Unit testing and integration testing
                  • Automated testing frameworks
                  • Agile/Scrum development
                  • Git-based development workflows

                Preferred Qualifications

                • Experience with healthcare billing platforms or RCM systems.
                • Experience developing CCM/RPM/RTM platforms specifically.
                • Knowledge of Medicare Advantage and value-based care models.
                • Experience working with provider organizations, MSOs, ACOs, or care management vendors.
                • Experience building AI-enabled clinical workflow solutions.
                • Experience with Azure AI, OpenAI, or healthcare analytics platforms.

                Desired Competencies

                • Strong problem-solving and analytical skills.
                • Ability to interpret CMS regulations and translate them into software requirements.
                • Excellent communication and collaboration skills.
                • Strong ownership mindset and customer focus.
                • Ability to balance technical excellence with business outcomes.

                Nice-to-Have Experience

                • Candidates with direct experience building products similar to:
                  • Chronic Care Management platforms
                  • Remote Patient Monitoring solutions
                  • Population Health Management systems
                  • Medicare billing and claims platforms
                  • Care coordination software
                  • Patient engagement platforms

                Benefits

                • 401k matching up to 3.5%
                • Medical, dental and vision coverage
                • Generous paid time off / holidays
                • Casual work environment
                • Work at home options (1-2 days a week)
                • Company social events

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