Clinical Intelligence Lead
Hike MedicalDigital Health company
San Francisco, United States$170,000 – $250,000Lead
Indicator Ventures
RiverPark Ventures
Rosecliff Venture Partners
Data & AI
About the role
TL;DR
Lead coding and medical policy expertise for AI systems, driving expansion into new device categories.
- •As Clinical Intelligence Lead, you will be the go-to expert on coding and medical policy at Hike, translating deep subject-matter expertise into structured logic for AI systems.
- •This role is crucial for scaling the company's operations into new device categories.
- •Key Responsibilities Own the coding intelligence layer, defining qualifying diagnoses, required documentation, and identifying gaps for HCPCS code blocks.
- •Translate clinical knowledge into structured agent guides and build the medical policy library.
- •Identify coding opportunities and documentation deficiencies to define rules for improvement.
- •Review HITL team outputs for coding accuracy and train new specialists.
- •Stay current with CMS policy changes and propagate them into agent guides.
- •Requirements 5+ years in DMEPOS coding with expertise in O&P and diabetic footwear.
- •Direct experience at a large DMEPOS company, O&P practice, or RCM firm.
- •Working knowledge of CMS LCDs, Policy Articles, and the CMS Required Prior Authorization List.
- •Ability to write precise, structured documentation for engineers.
- •Experience communicating with physicians and billers.
Required skills
PythonSQLExcelPowerPoint
Domain expertise
healthcare
Benefits & perks
competitive equity, full benefits
Tech stack
PythonSQLExcelPowerPoint