We are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in insurance verification, eligibility and benefits review, payer portal workflows, EDI 270/271 transactions, clearinghouse tools, front-end revenue cycle operations, and coverage discrepancy resolution.
This role supports current and upcoming remote consulting opportunities focused on AI-assisted insurance verification evaluation, eligibility and benefits workflow review, payer coverage assessment, and high-quality project execution. Selected professionals will apply front-end revenue cycle expertise to evaluate AI-generated eligibility outputs, identify coverage discrepancies, review payer compliance issues, and provide structured feedback based on detailed project criteria.
Key Responsibilities
Professionals in this role may contribute to:
Insurance Verification & Eligibility Review
- Review insurance verification, eligibility determination, and benefits investigation workflows across commercial, Medicare, Medicaid, and managed care payers
- Evaluate AI-generated eligibility verification outputs for accuracy, completeness, and payer compliance
- Assess coverage information gathered through payer portals, clearinghouses, and EDI 270/271 real-time eligibility transactions
- Identify coordination of benefits issues, coverage gaps, eligibility discrepancies, missing payer details, or inaccurate AI-generated coverage conclusions
Front-End Revenue Cycle Workflow Evaluation
- Review front-end revenue cycle workflows involving pre-service verification, benefit checks, coverage validation, payer requirements, and claim denial prevention
- Evaluate recommendations related to eligibility-related denial reduction, turnaround time improvement, verification accuracy, and process standardization
- Assess whether outputs align with Medicare, Medicaid, commercial payer, managed care, CMS, and payer-specific eligibility requirements
- Review KPIs such as verification accuracy rates, eligibility-related front-end denial rates, turnaround times, and workflow performance
Structured Feedback, Compliance & Quality Control
- Annotate AI-generated insurance verification and eligibility outputs and provide structured feedback to support quality improvement
- Evaluate content for alignment with HIPAA, payer-specific requirements, CMS guidelines, and front-end revenue cycle best practices
- Explain review decisions clearly, consistently, and with strong patient access and revenue cycle judgment
- Follow detailed task instructions, quality criteria, and project-specific review guidelines accurately
Ideal Profile
Strong candidates may have:
- 5+ years of experience in insurance verification, eligibility and benefits management, patient access, front-end revenue cycle operations, or related healthcare workflows
- At least 2 years of experience in a management, team lead, supervisor, or operational oversight role
- Expert knowledge of EDI 270/271 transactions, payer portal navigation, clearinghouse workflows, and real-time eligibility tools
- Strong familiarity with Medicare, Medicaid, commercial payer, and managed care eligibility requirements and benefit structures
- Proficiency with EHR platforms such as Epic, Cerner, Meditech, or similar systems
- Experience with clearinghouse platforms such as Availity, Change Healthcare, or similar tools
- Exceptional written and verbal English communication skills
- High attention to detail and ability to identify subtle discrepancies in coverage data, payer responses, and AI-generated eligibility outputs
Educational Background
- Professional background in insurance verification, eligibility and benefits, patient access, front-end revenue cycle operations, healthcare registration, financial clearance, billing, or healthcare business office functions is highly relevant
- Experience in hospitals, health systems, physician groups, patient access departments, payer-facing workflows, or multi-payer revenue cycle environments may be especially valuable
- Practical experience with EHR systems, payer portals, clearinghouses, eligibility tools, verification workqueues, and denial prevention workflows may support project fit
- Formal education in healthcare administration, business, health information management, finance, or a related field may be relevant depending on project scope
Nice to Have
- CHAM, CHAA, CRCR, or similar patient access or front-end revenue cycle certification
- Experience with automated eligibility verification tools, RPA solutions, or front-end revenue cycle technology platforms
- Background in denial root cause analysis related to eligibility, coordination of benefits, coverage errors, or registration issues
- Familiarity with AI tools and comfort evaluating AI-generated healthcare eligibility or coverage content
- Experience developing eligibility verification SOPs, benefits investigation workflows, payer reference guides, or front-end revenue cycle performance reports
- Experience presenting eligibility performance data, denial trends, or workflow improvement recommendations to senior leadership
Why This Opportunity
- Apply insurance verification and eligibility expertise to structured remote healthcare project work
- Contribute to high-quality AI-assisted front-end revenue cycle workflow evaluation
- Use payer portal, clearinghouse, EDI 270/271, and benefits investigation knowledge in a focused review environment
- Work on flexible assignments aligned with patient access, eligibility verification, coverage review, and denial prevention 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 $80 per hour depending on insurance verification experience, eligibility and benefits expertise, leadership 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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