Healthcare Administrative Specialist

Apply your healthcare operations expertise to create realistic, complex scenarios and supporting records that help train AI agents. This is focused authoring and evaluation work for experienced back-office professionals, with an emphasis on sound judgment rather than processing volume. Key Responsibilities

• Design complex, practice-area-specific healthcare operations scenarios.
• Build the records and documentation needed to support each scenario.
• Author and evaluate healthcare operations tasks for AI training.

• Medical coding, including inpatient, outpatient, professional-fee, risk adjustment/HCC coding, and coding audits.
• Prior authorization and utilization work, including submission, tracking through payer portals, utilization review, and utilization management.
• Revenue cycle operations, including denials and appeals, accounts receivable follow-up, payment and revenue integrity, underpayment recovery, coordination of benefits, and secondary billing.

• Claims, billing, and full-cycle medical billing.
• Regulatory compliance, HIPAA privacy, and healthcare internal audit.
• Payer operations, including claims adjudication, appeals and grievances, benefit configuration, provider networks, and utilization management.
• Coding audit, Clinical Documentation Integrity, DRG validation, and Health Information Management.
• Revenue integrity, charge master/CDM, managed care, and reimbursement analysis.
• Practice, clinic, or hospital administration, including Director or VP of Revenue Cycle experience.

• At least 3 years of recent, hands-on experience in a healthcare administrative or back-office role, and currently working in such a role.
• Direct experience with operational systems such as payer portals, including Availity, Optum/Change Healthcare, Waystar, Office Ally, or payer-specific hubs; EHR or practice-management systems; encoders and computer-assisted coding tools; and/or clearinghouses.
• Ability to commit at least 15 hours per week.

• Experience owning exceptions and disputes from start to finish, such as payer disputes or appeals.
• Experience conducting coding or DRG audits, defending code assignments through appeal, leading an EHR conversion or payer implementation, writing SOPs or payer-specific workflow documentation, supervising staff, or serving on a denials or audit committee.
• Senior-level expertise within a specialty, experience across two or more care settings, or experience on both provider and payer sides.

Experience may come from hospitals, physician groups and ambulatory practices, ambulatory surgery centers, skilled nursing and long-term care, home health and hospice, behavioral health, dialysis, infusion and specialty pharmacy, retail pharmacy and PBM prior authorization, DME suppliers, FQHCs, IDD and waiver services, health plans and TPAs, RCM outsourcers, or clearinghouses.

• Remote, hourly engagement.
• Compensation: $50 per hour.
• Primary market: United States. Candidates in Canada, the United Kingdom, Ireland, continental Europe, Australia, and New Zealand are also eligible.
• Applicants outside the United States should have experience with their own country’s insurance, funding, or billing system. US payer knowledge is welcome but not required.

This role is intended for healthcare administrative and operational specialists. It does not cover clinical care roles such as RN, LPN, NP, PA, physician, or pharmacist; EMT and paramedic roles; medical technician roles, including laboratory, radiology, surgical, pharmacy, sterile processing, respiratory, and phlebotomy; reception or front-desk check-in; patient registration; appointment scheduling or management; call-center script-following; medical scribing; or transcription-only work.