Billing SME - Product
Required skills
- Billing SME
- AI-powered billing
- revenue cycle
- claims
- payer rules
- denial management
- CPT
- ICD-10
- modifier rules
- AdvancedMD
Nice to have
- value-based care
- MSSP
- CPC+
- direct contracting
- EHR workflows
- CPC
Role summary
Elation is seeking a Billing SME to join their Billing Team and enhance AI-powered billing capabilities. This role requires hands-on primary care coding and RCM expertise to ensure AI features deliver accurate billing outcomes. The Billing SME will act as the liaison between the product team and the real-world billing landscape, providing domain feedback for AI development, managing billing risk, and defining success criteria for billing outputs. Responsibilities include user-zero testing of new AI billing features, providing front-line context on competitor systems, and partnering with Product and Design teams. The ideal candidate has 3+ years of primary care billing experience, deep knowledge of CPT/ICD-10/modifier rules, familiarity with practice management systems, and working knowledge of payer rules and claims workflows. Experience with EHR workflows and value-based care models is a plus.
You'll be the connective tissue between our product team and the real world of primary care billing — bringing hands-on RCM expertise to help us build AI that billing professionals actually trust.
Why This Role Exists
Accelerate Agentic Billing velocity. Your hands-on primary care coding and RCM expertise (e.g., AdvancedMD, Athena, or similar billing solutions) lets our team iterate on AI billing features with fast, credible domain feedback instead of waiting on live-customer validation for every coding or claims decision.
Manage billing risk and trust as AI takes on more of the revenue cycle. Coding and billing correctness carries real financial and compliance consequences — denials, CPT/ICD accuracy, payer rules. As AI authorship of billing decisions grows, you'll evaluate and safeguard accuracy and practice trust. You're the billing analog to the clinical-safety role our Clinical SMEs play for clinical AI.
What You'll Do
User Zero Testing — Feedback & Insight
Test new AI billing capabilities (coding suggestions, Auto-Queue, Worklist, ERA/payment posting) before wider release, evaluating them against real coding and billing judgment. You'll be the first eyes on every billing feature, providing the credible feedback that shapes the product.
Front-line Context & Grounding
Bring firsthand experience of how competitor and adjacent billing systems handle the same workflows, so our billing teams build with the broader RCM landscape in view — not just Elation's current implementation. Help us understand what "best in class" looks like.Billing Evaluation & Success Criteria
Define what "correct" means for coding and billing outputs — a billing-specific subset of user success criteria — and pressure-test AI-generated billing outputs before they reach practices. Your judgment protects practices from billing mistakes.
Design Partner
Sit alongside Product Design as a billing co-designer, providing billing and coding context and success criteria directly into the design process. Help architect workflows for process excellence by providing a high-level view of industry standards and differentiators.
Customer Partner & Key Contributor Support
Work with Product to act as the connective tissue between both billing teams and:
What Success Looks Like
You'll Wear Two Hats
Billing Co-Designer — Bring primary-care coding and RCM expertise into the design process the way Clinical SMEs bring clinical expertise: defining billing success criteria, front-line grounding, and user-zero testing.
Customer & Cross-Functional Liaison — Be the person Engagement Advisors, Support, and other SMEs escalate billing questions to, and who works directly with customer and design-partner accounts to turn real billing language into input GPT/Thor can act on.
What You'll Bring
Required:
Nice to Have:
What This Role Is Not
Elation welcomes individuals from all backgrounds and walks of life. Elation is proud to be an Equal Opportunity Employer and is dedicated to creating and maintaining a diverse and inclusive work environment.
We are committed to equal opportunity for all employees and applicants, and value individuals with diverse perspectives including, but not limited to: race, color, religion, sex, sexual orientation, socioeconomic status, age, gender identity or gender expression, national origin, disability or veteran status.
Elation also complies with all applicable national, state and local laws governing nondiscrimination in employment as well as work authorization and employment eligibility verification requirements of the Immigration and Nationality Act and IRCA. We firmly believe a strong culture that supports a diverse and inclusive workforce allows us to achieve Elation’s mission of helping independent primary care thrive.
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