SphereGen · 3 days ago
Revenue Cycle Management (RCM) Subject Matter Expert focusing on Sales
New Haven, CT
Full-time
Onsite
Mid, Senior Level
3+ years expSphereGen is an innovative software development and consulting company providing custom services in Intelligent Automation, Application Modernization and Support, Extended Reality. They are currently in need of an RCM Subject Matter Expert in healthcare to assist their Sales Team in Business Development and educate potential customers about RCM solution opportunities in relation to AI and Automation.
Business IntelligenceSoftwareVirtual Reality
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, and 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
Qualification
Required
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
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
Preferred
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
Company
SphereGen
SphereGen specializes in offering custom applications on multiple platforms including, web, mobile, iOS, virtual reality headset & HoloLens.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Anirudha Vengurlekar
CEO
Company data provided by crunchbase