Remote | Healthcare Operations & Revenue Cycle Specialist — \$35–\$45/hour

About the position

We are sharing a specialised part-time consulting opportunity for experienced healthcare administration professionals with hands-on expertise in patient access, prior authorisation, claims, revenue cycle operations, provider enrolment, payer workflows, and medical records administration. This role focuses on documenting and evaluating the real-world administrative workflows that keep medical practices, hospitals, and health plans operating effectively. Selected professionals will contribute practical knowledge of healthcare back-office processes, including the systems, decision points, handoffs, and operational steps involved from patient registration through claims payment and ongoing payer or provider administration.

Responsibilities

• Provide detailed insight into patient registration, scheduling, intake, and referral workflows
• Review insurance eligibility verification and benefits interpretation processes
• Explain how patient information moves between administrative systems and operational teams
• Identify common exceptions, bottlenecks, and escalation paths within front-end healthcare operations
• Document workflows for initiating, submitting, and tracking prior authorisation requests
• Explain how payer portals and supporting documentation are used throughout the authorisation process
• Review common approval, denial, follow-up, and escalation scenarios
• Identify operational differences across payer requirements and authorisation pathways
• Describe full-cycle claim submission, tracking, denial management, and accounts receivable follow-up
• Review processes for resolving rejected, denied, or underpaid claims
• Explain appeals workflows and supporting documentation requirements
• Assess how administrative teams move claims from initial submission through final payment or resolution
• Review electronic remittance advice, payment posting, and reconciliation workflows
• Document provider credentialing, enrolment, and payer configuration processes
• Explain appeals, grievances, member services, and provider-support operations where relevant
• Provide insight into medical records administration, release-of-information workflows, and daily practice-management activities

Requirements

• At least 3 years of daily, hands-on experience in a healthcare administrative or back-office role
• Current professional experience within healthcare administration or operations
• Direct ownership of one or more healthcare administrative workflows
• Experience with patient access, prior authorisation, revenue cycle, claims, provider enrolment, or health information management
• Strong understanding of how healthcare administrative processes operate across multiple systems and stakeholders
• Excellent written communication and attention to operational detail
• Ability to explain complex workflows clearly and sequentially
• Current residence in the United States

Nice-to-haves

• Experience as a Practice Administrator or Medical Office Manager
• Background as a Revenue Cycle Specialist or RCM Analyst
• Experience in medical billing or full-cycle billing
• Patient access, intake, referral, or scheduling expertise
• Prior authorisation experience
• Denials management or claims-resolution experience
• Credentialing or provider-enrolment experience
• Health plan or payer operations experience involving claims, appeals, grievances, or provider configuration
• Health Information Management or medical records administration experience
• Familiarity with Availity, Optum/Change Healthcare, Waystar, Office Ally, UHC Link, BCBS, Aetna, or comparable payer portals
• Experience with EHR, practice-management, or clearinghouse platforms
• A degree in healthcare administration, health information management, business administration, finance, or a related discipline may be helpful
• Professional training in revenue cycle management, medical billing, health plan operations, or practice administration may strengthen an application
• Relevant healthcare operations certifications may also be valuable
• Equivalent substantial hands-on healthcare administrative experience may be considered

Benefits

• Flexible remote work
• Competitive hourly compensation
• Weekly payments via Stripe or Wise