Healthcare Economics Domain Expert, Applied AI

Translucent AI is a company focused on transforming healthcare finance through AI solutions. They are seeking a Healthcare Economics Domain Expert to provide expertise in revenue cycle management and reimbursement economics, helping to develop AI-powered systems that enhance decision-making for finance teams.

Responsibilities:

• Develop and deliver subject-matter expertise in healthcare economics and revenue cycle management to support AI research, including reimbursement modeling, denial economics, payer contract analysis, and net revenue optimization
• Build analytical frameworks for the full revenue cycle: charge capture efficiency, coding accuracy and its financial impact, claims submission and adjudication patterns, denial root cause analysis, and collections performance
• Model payer-provider economics, including contract rate analysis, fee schedule benchmarking, allowable vs. billed variance, and the financial impact of payer mix shifts
• Develop frameworks for understanding reimbursement mechanics across Medicare (IPPS, OPPS, physician fee schedule), Medicaid, managed care, and commercial payers
• Analyze the economics of clinical operations, including physician productivity, procedure-level profitability, service line contribution margins, and cost-to-collect ratios
• Work closely with our engineering, product, and design teams to translate healthcare economic logic into production code and AI Agents
• Partner directly with customers to understand their revenue cycle pain points, identify financial leakage, and translate complex reimbursement and operational requirements into technical solutions
• Build proprietary benchmarks and datasets to evaluate models and AI Agents against real-world healthcare finance tasks, including denial rate analysis, days in A/R trending, net collection rate modeling, and payer performance scoring