Remote | Managed Care Payment Variance Review Consultant — Up to $65/hour
About The Position
We are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in underpayment recovery, managed care contract interpretation, payment variance analysis, payer reimbursement methodologies, contract compliance monitoring, and revenue cycle analytics. This role supports current and upcoming remote consulting opportunities focused on AI-assisted underpayment detection, managed care contract compliance review, payment variance evaluation, and high-quality project execution. Selected professionals will apply payer contract and reimbursement expertise to evaluate AI-generated underpayment alerts, review contract compliance outputs, identify payment discrepancies, and provide structured feedback based on detailed project criteria.
Requirements
- 5+ years of experience in underpayment recovery, payment variance analysis, managed care contracting, revenue cycle operations, or related healthcare finance functions
- Demonstrated expertise in payer contract interpretation and payment discrepancy analysis
- Deep knowledge of payer payment methodologies, including DRG-based, per diem, percent-of-billed charges, and fee schedule reimbursement
- Strong experience with contract modeling, payment reconciliation, payer dispute resolution, and underpayment recovery workflows
- Familiarity with managed care contract management systems, payment variance detection tools, and revenue cycle analytics platforms
- Proficiency with Excel-based financial analysis and healthcare revenue cycle data review
- Exceptional written and verbal English communication skills
- High attention to detail and ability to identify payment discrepancies in complex contract structures and AI-generated outputs
- United States-based professionals are required for this opportunity
Nice To Haves
- CHFP, CRCR, managed care contracting certification, or similar healthcare finance or revenue cycle credential
- Experience with contract management software such as Experian Health, Recondo, or similar platforms
- Background in hospital, health system, or large physician group underpayment recovery operations
- Familiarity with AI tools and comfort evaluating AI-generated payment variance, contract compliance, or reimbursement content
- Experience negotiating payer contracts or presenting underpayment analysis to managed care, finance, or executive leadership teams
- Strong ability to identify contract language issues, recurring payer underpayment patterns, and recovery prioritization opportunities
Responsibilities
- Review underpayment detection workflows involving commercial, Medicare Advantage, and Medicaid managed care payer contracts
- Evaluate AI-generated underpayment alerts, payment variance analyses, and contract compliance outputs for accuracy and completeness
- Identify payment discrepancies, systematic underpayment patterns, incorrect reimbursement logic, and unsupported variance findings
- Assess recovery opportunities involving claim payments, payer remittances, contract terms, and reimbursement methodologies
- Interpret managed care contract terms, including fee schedules, carve-outs, outlier provisions, payment methodologies, and payer-specific reimbursement rules
- Review contract modeling and payment reconciliation outputs to determine whether payments align with expected reimbursement terms
- Assess outputs involving DRG-based, per diem, percent-of-billed charges, fee schedule, and other payer payment structures
- Identify contract language gaps, payer behavior patterns, and potential renegotiation or recovery opportunities where relevant
- Annotate AI-generated payment variance and contract compliance outputs and provide structured feedback to support quality improvement
- Explain review decisions clearly, consistently, and with strong managed care and revenue cycle judgment
- Evaluate outputs for alignment with payer contract terms, HIPAA requirements, timely filing rules, and underpayment recovery workflows
- Follow detailed task instructions, quality criteria, and project-specific review guidelines accurately
Benefits
- Competitive hourly compensation
- Flexible scheduling
- Weekly payments
- Potential for project extensions
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What This Job Offers
Job Type
Part-time
Career Level
Senior
Education Level
No Education Listed
