Part Time Drg Validation Auditor Jobs (NOW HIRING)

Specialised Part-Time Consulting OpportunityWe 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.

Key ResponsibilitiesProfessionals in this role may contribute to: Underpayment & Payment Variance ReviewReview underpayment detection workflows involving commercial, Medicare Advantage, and Medicaid managed care payer contractsEvaluate AI-generated underpayment alerts, payment variance analyses, and contract compliance outputs for accuracy and completenessIdentify payment discrepancies, systematic underpayment patterns, incorrect reimbursement logic, and unsupported variance findingsAssess recovery opportunities involving claim payments, payer remittances, contract terms, and reimbursement methodologiesManaged Care Contract InterpretationInterpret managed care contract terms, including fee schedules, carve-outs, outlier provisions, payment methodologies, and payer-specific reimbursement rulesReview contract modeling and payment reconciliation outputs to determine whether payments align with expected reimbursement termsAssess outputs involving DRG-based, per diem, percent-of-billed charges, fee schedule, and other payer payment structuresIdentify contract language gaps, payer behavior patterns, and potential renegotiation or recovery opportunities where relevantStructured Feedback & Revenue Cycle Quality ControlAnnotate AI-generated payment variance and contract compliance outputs and provide structured feedback to support quality improvementExplain review decisions clearly, consistently, and with strong managed care and revenue cycle judgmentEvaluate outputs for alignment with payer contract terms, HIPAA requirements, timely filing rules, and underpayment recovery workflowsFollow detailed task instructions, quality criteria, and project-specific review guidelines accuratelyIdeal ProfileStrong candidates may have:5+ years of experience in underpayment recovery, payment variance analysis, managed care contracting, revenue cycle operations, or related healthcare finance functionsDemonstrated expertise in payer contract interpretation and payment discrepancy analysisDeep knowledge of payer payment methodologies, including DRG-based, per diem, percent-of-billed charges, and fee schedule reimbursementStrong experience with contract modeling, payment reconciliation, payer dispute resolution, and underpayment recovery workflowsFamiliarity with managed care contract management systems, payment variance detection tools, and revenue cycle analytics platformsProficiency with Excel-based financial analysis and healthcare revenue cycle data reviewExceptional written and verbal English communication skillsHigh attention to detail and ability to identify payment discrepancies in complex contract structures and AI-generated outputsEducational BackgroundProfessional background in healthcare revenue cycle operations, managed care contracting, underpayment recovery, reimbursement analysis, contract compliance, healthcare finance, or payer relations is highly relevantExperience in hospitals, health systems, large physician groups, revenue cycle departments, managed care teams, or payment integrity functions may be especially valuablePractical experience with contract management software, payment variance tools, payer dispute workflows, financial analysis, or reimbursement modeling may support project fitFormal education in healthcare administration, finance, accounting, business, economics, analytics, or a related field may be relevant depending on project scopeNice to HaveCHFP, CRCR, managed care contracting certification, or similar healthcare finance or revenue cycle credentialExperience with contract management software such as Experian Health, Recondo, or similar platformsBackground in hospital, health system, or large physician group underpayment recovery operationsFamiliarity with AI tools and comfort evaluating AI-generated payment variance, contract compliance, or reimbursement contentExperience negotiating payer contracts or presenting underpayment analysis to managed care, finance, or executive leadership teamsStrong ability to identify contract language issues, recurring payer underpayment patterns, and recovery prioritization opportunitiesWhy This OpportunityApply managed care contract and underpayment recovery expertise to structured remote healthcare project workContribute to high-quality AI-assisted payment variance detection and contract compliance evaluationUse reimbursement analysis, payer contract interpretation, and revenue cycle judgment in a focused review environmentWork on flexible assignments aligned with healthcare finance, managed care, underpayment recovery, and payment analytics expertiseRemote structure with competitive hourly compensationContract DetailsIndependent contractor roleFully remote with flexible schedulingUnited States-based professionals are required for this opportunityPart-time project-based commitment depending on availability, onboarding status, and project needsCompetitive rates of up to $65 per hour depending on underpayment recovery experience, managed care expertise, contract interpretation background, and project scopeWeekly payments via Stripe or WiseProjects may be extended, shortened, or adjusted depending on scope and performanceWork will not involve access to confidential or proprietary information from any employer, client, or institutionAbout the PlatformThis 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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