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Revenue Cycle Automation Consultant / SME

Remote · Kenya Full-time

About Valene Health Valene Health is an AI-native healthcare technology company building intelligent workflow automation solutions for healthcare organizations. Our platform helps providers streamline complex administrative and operational processes, reduce manual work, and improve efficiency across clinical and financial workflows. We’re looking for an experienced Revenue Cycle Automation Consultant / Subject Matter Expert (SME) to help translate real-world revenue cycle operations into scalable, technology-driven solutions.

About the Role

This is a hands-on, product-focused consulting role at the intersection of healthcare revenue cycle management (RCM), enterprise technology, and workflow automation . You’ll work directly with our product and engineering teams to define requirements, design workflows, and guide the development of AI-powered healthcare automation solutions. We’re seeking someone who understands not only how revenue cycle operations work, but also how these processes are implemented, integrated, and automated within healthcare technology systems . What You’ll Do Translate complex RCM processes into actionable product requirements, workflow diagrams, business rules, and technical specifications. Provide subject matter expertise across insurance eligibility, benefits verification, prior authorization, claims processing, and denial management . Identify automation opportunities, operational dependencies, exception scenarios, and human-in-the-loop requirements. Define data inputs/outputs, integration requirements, and system interactions across EHRs, practice management systems, clearinghouses, and payer platforms. Collaborate closely with engineers to validate solution designs, review implementation decisions, and support testing. Help prioritize capabilities based on operational feasibility, scalability, and measurable business impact. What We’re Looking For Required Qualifications 7+ years of experience in healthcare revenue cycle operations, RCM technology, or healthcare automation. Demonstrated hands-on understanding of eligibility verification, benefits verification, prior authorization, claims workflows, and denial management. Experience designing, implementing, or optimizing RCM technology solutions , not solely performing administrative RCM functions. Direct experience working with EHRs, practice management systems, clearinghouses, or payer connectivity platforms . Ability to translate operational workflows into structured product requirements, business logic, and engineering-ready specifications. Experience collaborating with software engineering, product, or healthcare IT teams. Strongly Preferred Previous experience at an RCM technology vendor, healthcare automation company, clearinghouse, or healthcare IT organization . Experience building or implementing provider-facing RCM software products. Familiarity with healthcare interoperability, APIs, and EDI/X12 transactions (270/271, 278, 837, 835, 276/277). Experience with platforms such as Epic, athenahealth, Oracle Health, Availity, or similar systems. Exposure to AI-driven automation, workflow orchestration, or intelligent process automation. Experience supporting specialty practices, ambulatory care organizations, or multispecialty medical groups. Who This Role Is For We’re particularly interested in professionals with backgrounds in: RCM Technology Product Management Revenue Cycle Solutions Architecture Healthcare Automation Consulting RCM Software Implementation & Integration Healthcare Revenue Cycle Transformation This is not a medical billing, coding, or traditional RCM operations position. We’re looking for someone with practical revenue cycle expertise who has also helped design, implement, or improve healthcare technology solutions. Similarly, candidates with purely software engineering backgrounds but limited hands-on RCM domain experience would not be the right fit.

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