Revenue Cycle Management (RCM) Subject Matter Expert focusing on Sales

Revenue Cycle Management (RCM) Subject Matter Expert focusing on Sales

SphereGen is an innovative software development and consulting company providing custom services in Intelligent Automation, Application Modernization and Support, Extended Reality. We develop business software applications across multiple platforms including web, mobile, Virtual, Augmented and Mixed Reality (HoloLens). Our specialization is in healthcare, however we support clients in the industries of manufacturing, and finance.

We are a growing company working on cutting edge technologies. Our team is a group of passionate, dedicated technology professionals who want to make a difference for our customers. Offices are located in New Haven, CT; Pune, India, and Toronto, Canada.

We are currently in need of an RCM Subject Matter Expert in healthcare, to assist our Sales Team in Business Development. This position will be working across departments, including Sales, Marketing and Development, to help strategize for and educate potential customers about RCM solution opportunities in relation to AI and Automation. This position works out of a new office we are establishing in Olympia Washington

We are Looking for Someone who is….

· Skilled in the knowledge of RCM workflow processes including integrations with different EHRs, clearing houses (Availity, Inovalon, WayStar) and payers.

· Experienced in RCM workflows including Patient Registration, Insurance Verification, Charge Capture, Coding, Claim Submission, Remittance Processing, Denial Management, Appeals, Collections, and Patient Financial Services.

· Confident and enjoys interacting with people. An effective communicator with strong verbal and written skills.

· Passionate about the benefits of technology – it's what we do and what we love. The job requires knowledge building in the areas of AI and Automation and how these technologies can improve workflow processes in healthcare.

· Able to drive enthusiasm in others – it's your chance to share your passion and knowledge for the subject while applying the benefits of technology.

· Creative and enjoys thinking outside the box to develop the strategy for custom process solutions.

· Curious and continually wants to learn and grow with the company

· Versatile quick learner who enjoys the challenge of unfamiliar tasks

Main Goal of the RCM Subject Matter Expert:

Work with potential customers and SphereGen Sales/Delivery to build an effective automation strategy for RCM workflows based on the customer's current and future needs.

Key Responsibilities:

• Deep-Dive into Hospital RCM Workflows:
• Leverage your expertise across the entire Revenue Cycle spectrum—Patient Access, Eligibility & Benefits Verification, Prior Authorization, Claims Management, Denial Management, Appeals, Payment Posting, and AR Follow-up—to identify automation opportunities.
• Payor-Provider Process Expertise:
• Bring a strong understanding of payer portals, clearinghouses, and provider-side RCM workflows. Help design automation use cases around tasks like claims status checks, authorization status retrieval, EOB/ERA posting, underpayment reviews, denials follow-up, and authorization retrievals from third party sites
• Sales Model Development for RCM Automation:
• Build RCM-specific sales models and solution frameworks that clearly outline:
• Target RCM processes for automation
• Expected business impact (e.g., cash flow improvement, FTE savings, reduction in days in AR, lower denial rates)
• Effort vs. benefit mapping for each RPA opportunity
• Phased roadmaps for large hospital RCM departments
• Develop and present automation business cases, TCO (Total Cost of Ownership) models, and ROI projections that will resonate with CFOs, Revenue Cycle VPs, and Hospital Operations leaders.
• Client-Specific Value Proposition Creation:
• Tailor value propositions and sales messaging based on each hospital's RCM KPIs (e.g., denial rates, clean claim ratios, aging AR buckets, first pass resolution rate, days in AR). Use your domain expertise to build credible, metric-driven narratives that connect AI and Automation solutions to revenue cycle performance goals.
• Active Role in Sales & Pre-Sales Conversations:
• Participate in sales discovery sessions, client workshops, and proposal defences. Present RCM automation use cases which align with hospital executives' business drivers.
• Process Assessments & Automation Road mapping:
• Conduct RCM process maturity assessments and help hospitals visualize a multi-phase automation roadmap, moving from quick wins (e.g., claims status automation) to enterprise-level transformations (e.g., end-to-end denial management automation).
• Thought Leadership in Healthcare Revenue Cycle Automation:
• Author whitepapers, contribute to webinars, and represent the company at healthcare RCM industry forums and events to position us as a leader in healthcare automation.
• Market & Competitive Intelligence:
• Monitor healthcare payment trends, regulatory changes, and RCM outsourcing/automation market movements. Use this intelligence to refine our solution packaging and pricing strategies for RCM automation offerings.

Requirements:

• 3-5+ years of leadership experience in Hospital Revenue Cycle Management (RCM), with roles such as Director, VP, or Chief Revenue Cycle Officer preferred.
• Strong expertise in US healthcare payer-provider workflows, hospital billing, collections, and revenue cycle operations.
• Proven experience engaging with hospital C-level executives, revenue cycle leaders, and operational teams.
• Exposure to process improvement, technology adoption, or automation initiatives in RCM.
• Excellent communication and presentation skills.
• Comfort working with both technical teams and client leadership to shape solution offerings.
• Experience in the US healthcare market is mandatory.

Preferred Qualifications:

• Experience with or exposure to Automation tools like UiPath, Power Automate, Blue Prism, etc.
• Background in consulting, business development, or solutioning for healthcare automation projects.
• Prior involvement in vendor-side sales support or client-facing solution roles in healthcare IT.
• Certified Revenue Cycle Representative or similar certification through Healthcare Financial Management Association (HFMA)