Remote Medical Billing & Prior Authorization SME (Contract)

Sustainable World, Inc.; Northern (KY); Hybrid; USD 99,000 - 136,000; Part time

Job summary

Exponent is hiring medical billers, coders, prior-authorization specialists, and verification experts as subject matter experts for a healthcare technology client. This is a remote, part-time, contract engagement. No protected health information is involved.

You will evaluate revenue-cycle and authorization workflows in a simulated environment and document where the environment differs from real-world practice. Start mid-September 2026, approx. 4 weeks, with ~10 hours per week, 1099 contractor.

Qualifications

• 5+ years in revenue cycle, coding, prior authorization, or pharmacy.
• 3+ years daily use of Availity, 3M Codefinder, CoverMyMeds, RightFax, athenahealth or MDLand iClinic.
• Current employment in the field, or left within the past two years.
• Working knowledge of CPT, ICD-10 and HCPCS for billing and coding.
• Preferred clinical/coding experience with 3M Codefinder and CoverMyMeds specifics.

Responsibilities

• Complete workflows in a simulated environment: eligibility and benefits verification, authorization submission and appeals, claim generation and scrubbing, remittance review, charge entry, coding and abstracting, and fax routing
• Identify steps that fail, behave differently from the production system, or are missing
• Document findings in structured forms and short written notes
• Attend a remote onboarding session and periodic check-ins

Skills

Revenue cycle

Prior authorization

Coding knowledge (CPT/ICD-10/HCPCS)

Documentation & reporting

Education

Healthcare credentials (CPC/CPB/CCS/RHIT/RHIA/CPhT)

Tools

Availity

3M Codefinder

CoverMyMeds

RightFax

athenahealth

MDLand iClinic

Job description

Exponent is hiring medical billers, coders, prior-authorization specialists, and verification experts as subject matter experts for a healthcare technology client. This is a remote, part-time, contract engagement. No protected health information is involved.

You will evaluate revenue-cycle and authorization workflows in a simulated environment and document where the environment differs from real-world practice. Start mid-September 2026, approx. 4 weeks, with ~10 hours per week, 1099 contractor.