We are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in denials management, appeals operations, payer denial analysis, clinical and technical appeals, denial prevention, revenue recovery, and healthcare billing workflows.
This role supports current and upcoming remote consulting opportunities focused on AI-assisted denials management evaluation, appeal content review, payer denial workflow assessment, root cause analysis, and high-quality project execution. Selected professionals will apply denials and appeals expertise to evaluate AI-generated appeal letters, review denial prevention recommendations, identify payer-specific issues, and provide structured feedback based on detailed project criteria.
Key Responsibilities
Professionals in this role may contribute to:
Denials Management & Appeal Review
- Review denials management workflows involving claim denial identification, categorization, resolution, and appeal strategy
- Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness
- Assess clinical and technical appeal content across commercial, Medicare, Medicaid, and managed care payers
- Identify weak appeal logic, missing documentation, unsupported arguments, payer-specific issues, or incomplete denial resolution strategies
Payer Denial Analysis & Revenue Recovery
- Analyze denial trends by payer, denial code, denial category, and operational root cause
- Review outputs involving CARC/RARC codes, payer denial patterns, appeal deadlines, reimbursement recovery, and claim resolution workflows
- Evaluate denial management KPIs such as denial rates, appeal overturn rates, revenue recovery, days in accounts receivable, and write-off trends
- Assess whether denial prevention recommendations are practical, compliant, and aligned with revenue cycle operations
Structured Feedback, Compliance & Quality Control
- Annotate AI-generated denial and appeal outputs and provide structured feedback to support quality improvement
- Evaluate content for alignment with payer appeal requirements, CMS regulations, timely filing deadlines, and internal revenue cycle standards
- Explain review decisions clearly, consistently, and with strong denials management judgment
- Follow detailed task instructions, quality criteria, and project-specific review guidelines accurately
Ideal Profile
Strong candidates may have:
- 5+ years of experience in denials management, appeals, revenue cycle operations, payer collections, or healthcare claims resolution
- At least 2 years of experience in a management, team lead, supervisor, or operational oversight role
- Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across commercial, Medicare, and Medicaid payers
- Strong understanding of clinical and technical appeal processes, including peer-to-peer reviews and external reviews
- Experience with denial analytics platforms, revenue cycle reporting tools, EHR systems, and billing platforms
- Exceptional written and verbal English communication skills
- High attention to detail and ability to evaluate appeal quality, denial logic, and AI-generated revenue cycle content
- Ability to work independently in a remote, project-based environment
Educational Background
- Professional background in healthcare revenue cycle operations, denials management, appeals, billing operations, coding, clinical documentation, payer follow-up, or claims resolution is highly relevant
- Experience in hospital, physician group, health system, payer-facing, or multi-payer revenue cycle environments may be especially valuable
- Practical experience with denial workqueues, appeal calendars, payer portals, billing systems, denial analytics tools, and revenue recovery workflows may support project fit
- Formal education in healthcare administration, business, finance, health information management, nursing, coding, or a related field may be relevant depending on project scope
Nice to Have
- CPC, CCS, CRCR, CHFP, or similar coding, revenue cycle, or healthcare finance credential
- Experience with AI-assisted denial management platforms or revenue cycle tools such as Waystar, Experian Health, Nthrive, or similar systems
- Background in complex clinical appeals, including medical necessity, experimental or investigational, level-of-care, or authorization-related denials
- Familiarity with AI tools and comfort evaluating AI-generated appeal, denial, and revenue cycle content
- Experience developing denial reduction action plans, payer-specific appeal strategies, SOPs, or performance reports for revenue cycle leadership
Why This Opportunity
- Apply denials management and appeals expertise to structured remote healthcare project work
- Contribute to high-quality AI-assisted denial prevention and appeal workflow evaluation
- Use payer denial analysis, appeal writing judgment, and revenue recovery experience in a focused review environment
- Work on flexible assignments aligned with healthcare revenue cycle, claim resolution, and denial management expertise
- Remote structure with competitive hourly compensation
Contract Details
- Independent contractor role
- Fully remote with flexible scheduling
- United States-based professionals are required for this opportunity
- Part-time project-based commitment depending on availability, onboarding status, and project needs
- Competitive rates of up to $70 per hour depending on denials management experience, appeals expertise, management background, and project scope
- Weekly payments via Stripe or Wise
- Projects may be extended, shortened, or adjusted depending on scope and performance
- Work will not involve access to confidential or proprietary information from any employer, client, or institution
About the Platform
This opportunity is available through 24-MAG LLC. We connect experienced professionals with remote consulting opportunities across technical, evaluation, and project-based workstreams.
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