Insurance Verification & Benefit Manager | $105/hr Remote
Overview
We're looking for a seasoned insurance verification and benefits specialist to help train cutting-edge AI systems for healthcare revenue cycle management. In this remote contract role, you'll apply your deep expertise in payer systems, EDI transactions, and eligibility workflows to evaluate and improve AI-generated outputs. It's a unique chance to directly influence the future of healthcare automation while earning a premium hourly rate.
What You'll Do8
- 1Oversee insurance verification, eligibility checks, and benefits investigations across commercial, Medicare, Medicaid, and managed care payers.
- 2Use payer portals, clearinghouses, and EDI 270/271 real-time transactions to confirm patient coverage before services are delivered.
- 3Resolve coordination of benefits issues, coverage gaps, and eligibility discrepancies to prevent claim denials.
- 4Assess AI-generated eligibility results for accuracy, completeness, and payer compliance, providing structured feedback for model training.
- 5Develop and maintain standard operating procedures for verification workflows to ensure consistency and efficiency.
- 6Monitor key performance indicators like verification accuracy, front-end denial rates related to eligibility, and turnaround times.
- 7Ensure all activities comply with CMS guidelines, HIPAA, and payer-specific requirements.
- 8Identify process gaps and recommend workflow improvements to reduce eligibility-related denials.
Requirements6
- 1At least 5 years of hands-on experience in insurance verification, eligibility management, or front-end revenue cycle operations, with a minimum of 2 years in a management or supervisory role.
- 2Expert-level proficiency with EDI 270/271 transactions, payer portals, and real-time eligibility verification tools.
- 3Strong knowledge of Medicare, Medicaid, and commercial payer eligibility rules and benefit structures.
- 4Hands-on experience with EHR platforms such as Epic, Cerner, or Meditech.
- 5Familiarity with clearinghouse platforms like Availity or Change Healthcare.
- 6Exceptional written and verbal English communication skills and high attention to detail.
Who Should Apply
This role is ideal for a revenue cycle veteran who loves precision and wants to apply their operational know-how to shape AI systems. You're comfortable with EDI transactions, can spot subtle coverage errors, and enjoy documenting workflows. If you're excited by the prospect of training AI to automate healthcare processes and have the hands-on experience to back it up, we'd love to hear from you.
Salary Insight
$105 per hour, remote contract position.
Application Tip
In your application, walk through a specific time you used EDI 270/271 transactions to resolve a complex eligibility issue—this will demonstrate the exact hands-on expertise the role demands.
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