Remote Medical Billing & Prior Authorization SME

ISHE; Northern (KY); Hybrid; USD 99,000 - 136,000; Part time

Job summary

Exponent is seeking a Medical Billing / Coding / Prior Authorization Subject Matter Expert for a remote, contract engagement. You will evaluate revenue-cycle workflows in a simulated environment and document differences from real-world practice.

Candidates should have 5+ years in revenue cycle or coding, 3+ years using Availity, 3M Codefinder, CoverMyMeds, and related tools, and be currently employed in the field or left within the past two years. Compensation is $72–$99 per hour.

Qualifications

• 5+ years in revenue cycle, coding, prior authorization, or pharmacy.
• 3+ years daily, hands-on use of Availity, 3M Codefinder, CoverMyMeds, RightFax, athenahealth, or MDLand iClinic.
• Currently employed in the field, or left within the past two years.
• CPC, CPB, CCS, RHIT, RHIA, or CPhT preferred.
• Working knowledge of CPT, ICD-10, and HCPCS for billing and coding.
• For 3M, inpatient coding or coding audit experience; for CoverMyMeds, daily prior-authorization work.
• Clear written communication.

Responsibilities

• Complete workflows in a simulated environment: eligibility, authorization, claims scrubbing, remittance review, charge entry, coding, and fax routing.
• Identify steps that fail or differ from production and document findings.
• Document findings in structured forms and notes.
• Attend a remote onboarding session and periodic check-ins.

Skills

Revenue cycle

Coding

Prior authorization

Pharmacy

Clear written communication

Education

CPC

CPB

CCS

RHIT

RHIA

CPhT

Tools

Availity

3M Codefinder

CoverMyMeds

RightFax

athenahealth

MDLand iClinic

Job description

Exponent is seeking a Medical Billing / Coding / Prior Authorization Subject Matter Expert for a remote, contract engagement. You will evaluate revenue-cycle workflows in a simulated environment and document differences from real-world practice.

Candidates should have 5+ years in revenue cycle or coding, 3+ years using Availity, 3M Codefinder, CoverMyMeds, and related tools, and be currently employed in the field or left within the past two years. Compensation is $72–$99 per hour.