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2 remote jobs found
AI Expert - Health Operations Contractor ↘ +6 regions
Mechanics AI Contracts +9 Authorization Reasoning Operations English Training Make Flexible Utilization Review Prior Authorization
  • Australia, Canada, Ireland +3New ZealandUnited KingdomUnited States
  • $40 – $125+ / hour
  • Sep 22, 2026

Models explain managed care in tidy theory and miss the mechanics that decide coverage: a benefit rule that overrides the general one, a prior-auth requirement waived in the contract, a utilization review that should have flagged the case.

AI Expert - Health Operations Contractor ↘ +6 regions
Mechanics AI Operations +8 Authorization Reasoning English Training Make Flexible Prior Authorization Revenue Cycle Operations
  • Australia, Canada, Ireland +3New ZealandUnited KingdomUnited States
  • $40 – $125+ / hour
  • Sep 22, 2026

Models describe the revenue cycle in clean theory and miss the mechanics that decide whether a claim pays: the real reason behind a CARC or RARC denial code, a payer rule that overrides the general one, an eligibility check that should have happened before the visit.

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