Senior Coding SME Operator

Ensemble Health Partners • Austin, TX

19h • Hybrid

About The Position

The Senior Coding SME Operator is a senior-level individual contributor responsible for identifying systemic coding variance and rework drivers, defining automation-ready coding logic and edge cases, and validating AI-assisted coding outputs for accuracy and compliance.

Operators serve as subject matter experts in specific revenue cycle domains while maintaining literacy across the end-to-end revenue cycle. They redesign workflows, identify upstream root causes, build knowledge graphs, participate in design sessions, and validate emerging automation and AI-driven models.

Requirements

• 5+ years of hands-on experience in the revenue cycle domain aligned to this role.
• Strong end-to-end revenue cycle literacy.
• Exceptional process mapping and process improvement capability.
• Data-driven problem solving and comfort with variance analysis.
• Ability to operate effectively in ambiguity; self-motivated and proactive.
• Strong communication skills for both technical and non-technical audiences.
• Curiosity and aptitude for automation, ML/AI, and agentic technologies.
• Demonstrated ability to lead problem-solving and redesign efforts independently (without formal authority).
• Proven ability to challenge existing processes constructively and propose more efficient methods.
• Comfort partnering closely with engineering/product teams to define, test, and iterate solutions.
• Ability to translate complex operational judgment into structured logic suitable for automation or AI.

Responsibilities

• Act as the domain SME while maintaining literacy across the full revenue cycle.
• Identify structural root causes that drive downstream rework, friction, and leakage.
• Design future-state workflows and operating models with measurable impact.
• Build and maintain domain-specific knowledge graphs capturing inputs, rules, actions, and outcomes.
• Participate in design sessions and rapid innovation sprints with product, engineering, and analytics teams.
• Test and validate automation, ML, AI, and agentic models using real operational scenarios.
• Translate SME judgment into rules, decision trees, training data, and guardrails.
• Support pilots and controlled rollouts with clear success criteria and measurement.
• Document operational logic and findings for reuse and scale.
• Identify coding variance, rework drivers, and systemic gaps.
• Define coding logic and edge cases for AI-assisted and autonomous models.
• Evaluate outputs of ML and agentic coding models for accuracy and compliance.
• Design feedback loops connecting documentation, coding, and payer outcomes.

Benefits

• We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed