Remote | Medical Billing & Claims Operations Consultant — Up to $60/hour

24-Mag•New York, NY

12h•Remote

About The Position

We are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in medical billing, claims submission, payer billing requirements, clearinghouse workflows, billing compliance, claim edits, electronic transactions, and revenue cycle operations. This role supports current and upcoming remote consulting opportunities focused on AI-assisted medical billing evaluation, claims workflow review, billing output assessment, and high-quality project execution. Selected professionals will apply billing and claims expertise to evaluate AI-generated billing outputs, review claim edits and payer requirements, identify compliance or submission issues, and provide structured feedback based on detailed project criteria.

Requirements

5+ years of experience in medical billing, claims management, revenue cycle operations, or healthcare billing workflows
At least 2 years of experience in a management, team lead, supervisor, or operational oversight role
Deep knowledge of professional fee billing, facility billing, or both
Strong understanding of CMS-1500, UB-04, 837P, 837I, HIPAA 837 transaction standards, clearinghouse operations, and payer-specific billing requirements
Experience with Medicare, Medicaid, commercial payer billing rules, claim edits, and rejection workflows
Proficiency with billing platforms such as Epic, Athenahealth, AdvancedMD, or similar systems
Exceptional written and verbal English communication skills
High attention to detail and ability to identify billing errors, compliance issues, and AI-generated output problems
Professional background in medical billing, healthcare revenue cycle operations, claims submission, billing management, coding support, claims editing, or healthcare business office functions is highly relevant
United States-based professionals are required for this opportunity

Nice To Haves

Experience in hospital, health system, physician group, multi-specialty practice, or payer-facing billing environments may be especially valuable
Practical experience with billing systems, clearinghouse tools, claim scrubbers, payer portals, coding validation workflows, and billing compliance processes may support project fit
Formal education in healthcare administration, health information management, business, finance, accounting, coding, or a related field may be relevant depending on project scope
CPC, CCS, CHFP, CRCR, or similar coding, healthcare finance, or revenue cycle credential
Experience with automated billing platforms, revenue cycle technology implementations, or billing workflow optimization
Background in multi-specialty physician group, hospital, or health system billing operations
Familiarity with AI tools and comfort evaluating AI-generated billing and claims content
Experience with payer contract interpretation, billing compliance program management, billing SOPs, or payer-specific reference guide development

Responsibilities

Review end-to-end medical billing and claims submission workflows across professional fee and facility billing environments
Evaluate AI-generated billing outputs, claim edits, coding validations, and claims submission recommendations for accuracy and payer compliance
Assess electronic claim generation, clearinghouse edits, payer-specific billing rules, and submission readiness
Identify billing errors, missing claim information, payer-specific issues, compliance gaps, or incomplete AI-generated claim guidance
Review billing workflows involving Medicare, Medicaid, commercial payers, professional claims, facility claims, and payer-specific requirements
Evaluate outputs related to clean claim rates, rejection rates, first-pass acceptance rates, and claim resolution strategies
Assess whether billing recommendations align with CMS billing guidelines, payer rules, HIPAA 837 transaction standards, and revenue cycle best practices
Support review of coordination points between billing, coding, clinical documentation improvement, collections, and claims follow-up teams
Annotate AI-generated billing and claims content and provide structured feedback to support quality improvement
Explain review decisions clearly, consistently, and with strong medical billing operations judgment
Evaluate billing content for accuracy, compliance, payer alignment, and practical workflow usefulness
Follow detailed task instructions, quality criteria, and project-specific review guidelines accurately