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

24-Mag•New York, NY

5d•Remote

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.

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

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