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New York, New York, United States Or refer someone Job Openings Remote | Insurance Verification and Benefits Eligibility Consultant — Up to $80/hour

We are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in insurance verification, eligibility and benefits review, payer portal workflows, EDI 270/271 transactions, clearinghouse tools, front-end revenue cycle operations, and coverage discrepancy resolution.

This role supports current and upcoming remote consulting opportunities focused on AI-assisted insurance verification evaluation, eligibility and benefits workflow review, payer coverage assessment, and high-quality project execution. Selected professionals will apply front-end revenue cycle expertise to evaluate AI-generated eligibility outputs, identify coverage discrepancies, review payer compliance issues, and provide structured feedback based on detailed project criteria.

Professionals in this role may contribute to:

• Review insurance verification, eligibility determination, and benefits investigation workflows across commercial, Medicare, Medicaid, and managed care payers
• Evaluate AI-generated eligibility verification outputs for accuracy, completeness, and payer compliance
• Assess coverage information gathered through payer portals, clearinghouses, and EDI 270/271 real-time eligibility transactions
• Identify coordination of benefits issues, coverage gaps, eligibility discrepancies, missing payer details, or inaccurate AI-generated coverage conclusions

• Review front-end revenue cycle workflows involving pre-service verification, benefit checks, coverage validation, payer requirements, and claim denial prevention
• Evaluate recommendations related to eligibility-related denial reduction, turnaround time improvement, verification accuracy, and process standardization
• Assess whether outputs align with Medicare, Medicaid, commercial payer, managed care, CMS, and payer-specific eligibility requirements
• Review KPIs such as verification accuracy rates, eligibility-related front-end denial rates, turnaround times, and workflow performance

• Annotate AI-generated insurance verification and eligibility outputs and provide structured feedback to support quality improvement
• Evaluate content for alignment with HIPAA, payer-specific requirements, CMS guidelines, and front-end revenue cycle best practices
• Explain review decisions clearly, consistently, and with strong patient access and revenue cycle judgment
• Follow detailed task instructions, quality criteria, and project-specific review guidelines accurately

Strong candidates may have:

• 5+ years of experience in insurance verification, eligibility and benefits management, patient access, front-end revenue cycle operations, or related healthcare workflows
• At least 2 years of experience in a management, team lead, supervisor, or operational oversight role
• Expert knowledge of EDI 270/271 transactions, payer portal navigation, clearinghouse workflows, and real-time eligibility tools
• Strong familiarity with Medicare, Medicaid, commercial payer, and managed care eligibility requirements and benefit structures
• Proficiency with EHR platforms such as Epic, Cerner, Meditech, or similar systems
• Experience with clearinghouse platforms such as Availity, Change Healthcare, or similar tools
• Exceptional written and verbal English communication skills
• High attention to detail and ability to identify subtle discrepancies in coverage data, payer responses, and AI-generated eligibility outputs

• Professional background in insurance verification, eligibility and benefits, patient access, front-end revenue cycle operations, healthcare registration, financial clearance, billing, or healthcare business office functions is highly relevant
• Experience in hospitals, health systems, physician groups, patient access departments, payer-facing workflows, or multi-payer revenue cycle environments may be especially valuable
• Practical experience with EHR systems, payer portals, clearinghouses, eligibility tools, verification workqueues, and denial prevention workflows may support project fit
• Formal education in healthcare administration, business, health information management, finance, or a related field may be relevant depending on project scope

• CHAM, CHAA, CRCR, or similar patient access or front-end revenue cycle certification
• Experience with automated eligibility verification tools, RPA solutions, or front-end revenue cycle technology platforms
• Background in denial root cause analysis related to eligibility, coordination of benefits, coverage errors, or registration issues
• Familiarity with AI tools and comfort evaluating AI-generated healthcare eligibility or coverage content
• Experience developing eligibility verification SOPs, benefits investigation workflows, payer reference guides, or front-end revenue cycle performance reports
• Experience presenting eligibility performance data, denial trends, or workflow improvement recommendations to senior leadership

• Apply insurance verification and eligibility expertise to structured remote healthcare project work
• Contribute to high-quality AI-assisted front-end revenue cycle workflow evaluation
• Use payer portal, clearinghouse, EDI 270/271, and benefits investigation knowledge in a focused review environment
• Work on flexible assignments aligned with patient access, eligibility verification, coverage review, and denial prevention expertise
• Remote structure with competitive hourly compensation

• Independent contractor role
• Fully remote with flexible scheduling
• United States-based professionals are required for this opportunity
• Part-time project-based commitment depending on availability, onboarding status, and project needs
• Competitive rates of up to $80 per hour depending on insurance verification experience, eligibility and benefits expertise, leadership background, and project scope
• Weekly payments via Stripe or Wise
• Projects may be extended, shortened, or adjusted depending on scope and performance
• Work will not involve access to confidential or proprietary information from any employer, client, or institution

This 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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