Operations Automation Specialist
Core
Resolve provider claims inquiries manually while building AI-assisted workflows to automate resolution and reduce future ticket volume.
Role type
Operations Automation Specialist (hybrid IC/Builder)
Builds
AI-assisted workflows for claims triage, validation, and provider response drafting
Domain
Healthcare operations / Claims processing / Revenue cycle
Deliverable
production ML models | product features
Required skills
Claims resolution, SQL, Python, AI tooling (agentic coding), process improvement, stakeholder communication
Preferred skills
Revenue cycle/claims domain knowledge, business/finance background, support/ops experience
Technologies
SQL, Python, Databricks, Claude Code
Responsibilities
Resolve live provider claims inquiries (status, payment, denial), audit claims across systems, query claims/pricing data to identify root causes, design and build AI-assisted workflows, test automation against real ticket volume, push upstream fixes for deferred claims or ingestion errors
Seniority
Individual Contributor (open to recent grads to 10+ years experience)
