You will get an AI medical claims denial and prior authorization system
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Top Rated
Project details
You will get a custom AI medical claims denial and prior authorization system designed for healthcare providers, medical billing teams, RCM companies, and health technology platforms. The solution can analyze claim denials, classify denial reasons, extract data from medical documents, explain root causes, recommend corrective actions, and support prior authorization workflows.
Unlike a basic chatbot, this project focuses on practical healthcare automation that reduces manual review, improves claim accuracy, accelerates approvals, and supports revenue cycle management. Depending on your selected package, I can deliver an AI prototype, a working MVP with dashboard and database, or a production ready platform with integrations, deployment, monitoring, testing, documentation, and source code.
The system can be customized around your existing workflow, forms, payer rules, APIs, database, billing platform, or internal process. Human review can remain part of the workflow for accuracy and operational control.
Before placing an order, please initiate a discussion to ensure alignment of requirements.
Unlike a basic chatbot, this project focuses on practical healthcare automation that reduces manual review, improves claim accuracy, accelerates approvals, and supports revenue cycle management. Depending on your selected package, I can deliver an AI prototype, a working MVP with dashboard and database, or a production ready platform with integrations, deployment, monitoring, testing, documentation, and source code.
The system can be customized around your existing workflow, forms, payer rules, APIs, database, billing platform, or internal process. Human review can remain part of the workflow for accuracy and operational control.
Before placing an order, please initiate a discussion to ensure alignment of requirements.
AI Algorithms
Large Language Model, Multimodal Large Language Model, Transformer ModelAI Applications
AI Chatbot, AI Content Creation, AI Text-to-Image, AI Text-to-Speech, AI-Enhanced Classification, AI-Enhanced Medical Imaging, Anomaly Detection, Automatic Speech Recognition, Conversational AI, Facial Recognition, Image AnalysisAI Development Language
PythonAI Tools
Adobe Firefly, Azure OpenAI, Bing AI, GitHub Copilot, Hugging Face, Jasper AI, Microsoft 365 Copilot, NVIDIA AI Platform, PyTorch, TensorFlowAI Models
BERT, ChatGPT, DALL-E, GPT-3, GPT-4, GPT-J, GPT-Neo, LaMDA, LLaMA, Midjourney AI, OpenAI Codex, WhisperWhat's included
| Service Tiers |
Starter
$900
|
Standard
$2,500
|
Advanced
$5,500
|
|---|---|---|---|
| Delivery Time | 7 days | 14 days | 25 days |
Number of Revisions | 2 | 3 | 5 |
AI Model Integration | |||
Batch Normalization | - | - | - |
Database Integration | - | ||
Detailed Code Comments | - | ||
Image Upscaling | - | - | |
MLOps | - | - | |
Model Deployment | - | ||
Model Documentation | |||
Model Monitoring | - | - | |
Model Testing & Optimization | |||
Model Tuning | - | - | |
Natural Language Processing | |||
NLP Tokenization | |||
Pre-Training | - | - | - |
Prompt Engineering | |||
Setup File | |||
Source Code |
Frequently asked questions
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About Mirza Omer
Expert AI Engineer | LLMs, RAG, Agents | SaaS MVP | PhD AI
100%
Job Success
Mississauga, Canada - 11:12 pm local time
I've built AI systems that process 100,000 calls a day, NLP models used in cancer treatment planning, conversational AI deployed across enterprise voice and text channels, and agentic workflows running inside Fortune 500 operations.
I'm Dr. Omer, PhD from the University of Waterloo, and formerly Senior Director of AI R&D at Afiniti, a global enterprise AI company whose outcome orchestration platform serves Fortune 500 clients across Telco, Financial Services, and Healthcare.
That background shapes how I approach every project: I ask whether this is the right AI architecture for the real business problem, not just the most popular framework at the moment.
Production AI systems I've built and led:
🎯 Afiniti Enterprise Contact Center AI — As Senior Director of AI R&D, led development of Afiniti's AI product suite: behavioral pairing systems matching agents to customers in real time, outcome orchestration engines, and intelligent automation deployed across Fortune 500 contact centers globally in Telco, FinTech, and Healthcare
🎯 Automated AI Evaluation at Scale — Etisalat / PTCL — Designed and deployed an AI-based near real-time contact center evaluation system processing 100,000+ calls per day — replacing manual QA at scale for one of the region's largest telecom operators (Etisalat holds a 26% stake in PTCL)
🎯 Conversational AI Systems — Built end-to-end conversational AI pipelines for enterprise clients across voice and text channels, covering multi-turn dialogue management, intent recognition, LLM-based response generation, and integration with CRM and ticketing systems
🎯 NLP Models for Cancer Treatment Planning — Developed NLP models supporting clinical oncology workflows — applied NLP at the intersection of language understanding and life-critical treatment decisions
Where I'm most useful:
→ You're building an LLM-powered product and need the architecture designed before your team writes a line of code
→ You need a RAG system or AI chatbot that handles real user behavior — not just curated demos
→ You want n8n, Make, or Zapier automation connected intelligently to LLM workflows
→ Your contact center, healthcare, or operations team generates high-volume data that AI should be processing automatically
→ You need a senior technical opinion on AI architecture, model selection, or agentic system design
What I build:
✅ LLM Application Development — GPT-4o, Claude, LLaMA, Mistral, Gemini, Ollama
✅ AI Chatbot Development — customer support bots, lead qualification bots, internal knowledge bots
✅ Conversational AI — multi-turn dialogue, intent recognition, slot filling, voice + text channels
✅ RAG Pipelines & Knowledge Systems — vector store design, chunking strategy, hybrid retrieval, evaluation
✅ Agentic AI & Multi-Agent Systems — LangGraph, CrewAI, AutoGen, tool-use agents, OpenClaw
✅ Workflow Automation — n8n, Make, Zapier, AI-connected automation pipelines
✅ Voice AI & Speech Systems — Vapi, Retell AI, Whisper, Deepgram, ElevenLabs, STT/TTS pipelines
✅ NLP Systems — text classification, NER, keyphrase extraction, summarization, clinical NLP
✅ Document AI — intelligent document processing, extraction pipelines, unstructured data handling
✅ Contact Center AI — automated call scoring, behavioral modeling, real-time agent assistance
✅ Healthcare AI — clinical document processing, treatment decision support, medical NER
✅ Fine-tuning & Optimization — LoRA, QLoRA, RLHF, DPO, prompt optimization, model evaluation
Tech stack:
LLMs & Agent Frameworks:
GPT-4o · Claude API · LLaMA 3 · Mistral · Gemini · Ollama · LangChain · LangGraph · LlamaIndex · DSPy · HuggingFace Transformers · CrewAI · AutoGen · OpenClaw · Semantic Kernel
Automation & Workflow:
n8n · Make (Integromat) · Zapier · Webhook integrations · API orchestration · event-driven pipelines
NLP & ML:
PyTorch · TensorFlow · SpaCy · NLTK · Scikit-learn · Sentence Transformers · BERT · T5 · Whisper · OpenCV
Voice & Conversational AI:
Vapi · Retell AI · Whisper · Deepgram · ElevenLabs · Amazon Polly · RASA · Botpress · STT/TTS
RAG & Vector Databases:
Pinecone · Weaviate · ChromaDB · pgvector · FAISS · Qdrant · Milvus
Fine-tuning & Evaluation:
LoRA · QLoRA · RLHF · DPO · Axolotl · Unsloth · LangSmith · MLflow · RAGAS · TruLens
Deployment & Infrastructure:
Python · FastAPI · Flask · Docker · Kubernetes · AWS (SageMaker · Lambda · EC2) · GCP Vertex AI · Azure ML · Prometheus · Grafana
[AI Engineer · AI Developer · LLM Developer · NLP Engineer · AI Consultant · Agentic AI · AI Agent Developer · LangChain Developer · LangGraph · RAG Developer · Retrieval Augmented Generation · AI Chatbot Developer · Conversational AI · Chatbot Development · AI Automation · Workflow Automation · n8n · n8n Developer · Make Automation · Zapier Integration · OpenClaw · OpenClaw Developer · Voice AI · Voice Agent · Contact Center AI · Healthcare AI }
Steps for completing your project
After purchasing the project, send requirements so Mirza Omer can start the project.
Delivery time starts when Mirza Omer receives requirements from you.
Mirza Omer works on your project following the steps below.
Revisions may occur after the delivery date.
Requirements and Workflow Review
I review your denial management or prior authorization workflow, sample documents, required outputs, user roles, integrations, security needs, and success criteria.
Solution Design and AI Development
I design the AI workflow, data extraction logic, denial classification, corrective action rules, database structure, dashboard. Then I build the document processing, denial analysis, recommendations, prior authorization automation, & API integrations