Healthcare Administrative Specialist

Job Description

Job Description

About the Opportunity

KC Elite Staffing is seeking experienced healthcare administrative and operations professionals for a remote contract opportunity. This is authoring and judgment-based work — not volume processing. You will draw on your real-world expertise to design realistic scenarios, build supporting documentation, and evaluate healthcare operations tasks. If you are a seasoned healthcare back-office professional who owns complex problems, this role was built for you.

Priority Areas — Hiring Immediately

We are actively seeking candidates with hands-on experience in one or more of the following:

• Medical Coding — inpatient, outpatient, pro-fee, risk adjustment/HCC coding, coding audits
• Prior Authorization & Utilization Management — submitting and tracking authorizations through payer portals, utilization review
• Revenue Cycle Operations — denials and appeals, A/R follow-up, payment integrity, underpayment recovery, coordination of benefits, secondary billing

Also In Scope

• Claims and full-cycle medical billing
• Regulatory compliance and HIPAA privacy
• Healthcare internal audit
• Payer-side operations — claims adjudication, appeals and grievances, benefit configuration, provider network, utilization management
• Clinical Documentation Integrity (CDI), DRG validation, Health Information Management
• Revenue integrity, charge master (CDM), managed care and reimbursement analysis
• Practice, clinic, and hospital administration
• Director/VP of Revenue Cycle level experience welcome

Requirements

• 3+ years of hands-on, recent experience in a healthcare administrative or back-office role
• Currently working in a qualifying role
• Direct experience with payer portals such as Availity, Optum/Change Healthcare, Waystar, Office Ally, or individual payer hubs
• Familiarity with EHR/practice management platforms, encoders, computer-assisted coding tools, and/or clearinghouses
• Ability to commit 15+ hours per week
• Must be located in the United States
• Must be authorized to work as an independent contractor — H1-B and STEM OPT candidates cannot be considered at this time

What Makes a Strong Candidate

We are looking for professionals who can construct and solve complex problems — not process volume. Strong candidates will have experience such as:

• Owning an appeal or payer dispute end to end
• Running coding or DRG audits
• Defending a code assignment through appeal
• Leading an EHR conversion or payer implementation
• Writing SOPs or payer-specific workflow documentation
• Supervising staff or sitting on a denials or audit committee
• Experience across two or more care settings or on both the provider and payer side

Settings We Consider

Physician groups, 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, health plans and TPAs, RCM outsourcers and clearinghouses.

Not a Fit For

Clinical care roles, front desk, patient registration, appointment scheduling, call center script-following, medical scribes, or transcription-only roles.

How to Apply

Submit your application through KC Elite Staffing. Qualified candidates will receive next steps via email within 1–2 business days.