Richard Qi Shi

About Richard Qi Shi

Senior Software Engineer focused on workflow/state-machine systems, data correctness, and scalable backend architecture, with deep experience in healthcare/insurance automation (Prior Authorization / Coverage workflows).At Phil, I led PA/coverage initiatives that improved coverage outcomes and operational throughput—rebuilding complex workflows, strengthening auditability via event/log-based history, and shipping high-risk data repair/backfill changes with “do-no-harm” safeguards. Results included 45% fewer duplicate PA starts,~50% fewer Ops escalations tied to PA date/record issues, and 90%+ alignment across Ops and analytics dashboards. I also built an LLM-based clinical note extraction workflow (categorization + field extraction), improving model accuracy to ~98% through iterative evaluation and error analysis.I’m exploring Senior/Staff backend or platform roles where I can own end-to-end systems: orchestration, integrations, reliability, and measurable business impact.

Experience

1. Senior Software Engineer

   PHIL, Inc.

   Aug 2021 — Present · San Francisco, CA, US

   Led PA/Coverage workflow + data-correctness initiatives, delivering 45% fewer duplicate PA starts,~50% fewer Ops escalations, and 90%+ dashboard metric alignment by improving callback handling, state/dedupe logic, and shared metric definitions- Architected a distributed PA orchestration approach (workflow/state machine), defining integration boundaries across vendor callbacks and internal services, with idempotency/retry patterns to improve transparency and reliability- Built a production-safe data repair/backfill pipeline across PostgreSQL + MongoDB with snapshot cutoffs and “do-no-harm” stop conditions to backfill missing denial fields and sync corrected state to live orders- Built an LLM-based clinical note extraction workflow (categorization + field extraction), improving accuracy to ~98% through prompt iteration, evaluation, and targeted error analysis- Mentored engineers (including offshore) and drove cross-functional delivery for insurance exception resolution (rejection mapping, workflow UX, instrumentation)- Owned and evolved key operational integrations (support tooling), improving reliability and response workflows through iterative enhancements and ongoing maintenance- Partnered with stakeholders to clarify requirements under ambiguity, break down initiatives into milestones, and uphold quality through code reviews and disciplined releases.

Education

• College of the Desert

  General Study

  2011 — 2013

• UC Irvine

  Bachelor of Science (B.S.), Electrical, Electronics and Communications Engineering

  2013 — 2016

• UC Irvine

  Master of Science - MS, Electrical, Electronics and Communications Engineering