RCM AI Compliance Director

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ModMed

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

ModMed is a healthcare technology company that provides specialty-specific electronic health record (EHR) software, practice management, revenue cycle management, analytics, and patient communication tools for medical practices. Their platform integrates AI-powered features—like ModMed Scribe—for clinical documentation, workflow automation, billing assistance, and patient engagement to help specialty physicians streamline operations and improve efficiency. ModMed focuses on serving specialty practices (dermatology, ophthalmology, gastroenterology, orthopedics, OBGYN, etc. ) with onboarding, support, and integrations (FHIR API, telehealth, payment processing).

📋 Description

• Review technical requirements to ensure the AI Platform complies with current coding and billing regulations • Determine appropriate and compliant modeling data while maintaining patient privacy and billing integrity • Review and approve AI assistant or agent recommendations • Define caveats and guardrails for AI-generated outputs • Assess the RCM regulatory landscape, including payer requirements and coding updates • Identify risks associated with automated workflows • Align Legal, Compliance, and RCM Operations on the organization’s AI risk tolerance • Maintain documented compliance controls for AI workflows • Partner with internal audit to keep the platform transparent and auditable

🎯 Requirements

• Bachelor’s Degree in a related field • 10+ years in RCM, healthcare coding, compliance, or billing • Active, hands-on experience in billing and healthcare operations • Deep understanding of RCM workflows, payer rules, and compliance risk management • Proven experience implementing compliance programs within high-tech, SaaS, or AI-driven environments • Ability to convert vague compliance guidelines into programmatic technical policies for AI models • Ability to serve as a firm compliance gatekeeper and productive partner to technical Product teams • Ability to translate complex regulatory requirements into practical guidelines for senior leaders and engineers

🏖️ Benefits

• Comprehensive medical, dental, and vision benefits • Company Health Savings Account contribution • 401(k) matching contribution of 50% of contributions deferred on up to 6% of compensation • 100% vesting of matching contributions after one year of employment • Generous Paid Time Off • Paid Parental Leave • Company-paid Life and Disability benefits • Flexible Spending Account • Employee Assistance Programs • Company-sponsored Business Resource & Special Interest Groups • Professional development opportunities • Tuition reimbursement programs • Unlimited access to LinkedIn Learning • Remote availability for some roles