Clinical Subject Matter Expert (Healthcare AI)

Location: Remote - US; candidates must be authorized to work in the United States without current or future employer sponsorship.

Salary: $125K–$147K, plus equity.

Company

hirify.global combines software, data, service, and AI to help healthcare providers dispute underpaid claims and recover fair reimbursement.

What you will do

• Review AI-drafted position statements for facility claims, assess clinical credibility, and identify weak reasoning or inadequate descriptions of care.
• Define standards for persuasive clinical arguments and convert them into guidance for Product and Engineering.
• Annotate statements, track quality changes, and design and run evaluation criteria and test sets as models and templates evolve.
• Define the clinical and billing context required for different claim types and write product requirements for collecting and using it.
• Partner with Product and Engineering as the clinical subject matter expert and incorporate reviewer, operations, and client-facing feedback into product improvements.
• Extend facility-claims expertise across coding, billing, reimbursement, bundled charges, and billing-code sourcing.

Requirements

• Clinical background, typically nursing, with 5+ years of experience in clinical documentation, denials, or appeals.
• Hands-on experience writing or reviewing appeals, denial responses, or clinical arguments intended to persuade a payer, with specific outcomes to discuss.
• Working knowledge of facility billing, coding, and reimbursement, including the relationship between claims, charges, and codes.
• Experience providing structured, consistent feedback on written work, including annotating or scoring drafts against a rubric.
• Ability to convert clinical judgment into clear written requirements and criteria for engineers and product managers.
• Comfort working in a product team where processes are still being built, ideally in a startup or technology company.
• Curiosity about how AI models learn and fail, plus the directness to identify when a statement is inadequate and explain why.

Nice to have

• Experience in revenue integrity, utilization review, or clinical documentation improvement for hospitals or health systems.
• Familiarity with the No Surprises Act or Independent Dispute Resolution.
• Experience with 835/837 claims data or evaluating AI-generated content.

Culture & Benefits

• Collaborative, low-ego team focused on improving healthcare reimbursement for providers.
• Competitive compensation including equity.
• Full health, dental, and vision coverage.
• Retirement savings plan through 401(k), flexible time off, and company-wide connection and events.
• Remote flexibility for this role; the company primarily hires around Los Angeles and New York hubs.
• Employment is at-will and contingent on applicable background checks where permitted by law.