Claims Processing Expert - Fully Remote | Upto $80/hr
About the job
Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .
Position: Medical Billing Manager
Type: Contract
Compensation: $80/hour
Location: Remote
Role Responsibilities
- Oversee end-to-end medical billing and claims submission operations across professional fee and/or facility billing environments.
- Evaluate AI-generated billing outputs , claim edits, and coding validations for accuracy and payer compliance.
- Manage claims submission workflows including electronic claim generation, clearinghouse edits, and payer-specific billing requirements.
- Monitor clean claim rates, rejection rates, and first-pass acceptance rates. Develop improvement strategies.
- Coordinate with coding, CDI, and collections teams to resolve billing edits and claim rejections.
- Ensure compliance with CMS billing guidelines , HIPAA 837 transaction standards , and payer-specific billing rules.
- Annotate AI outputs and provide structured feedback to support AI training datasets .
Qualifications
Must-Have
- 5+ years of experience in medical billing and claims management, with at least 2 years in a management role.
- Deep knowledge of professional fee ( CMS-1500/837P ) and/or facility ( UB-04/837I ) billing requirements.
- Expertise in HIPAA 837 transaction standards , clearinghouse operations, and payer-specific billing rules.
- Strong understanding of Medicare , Medicaid , and commercial payer billing requirements.
- Proficiency with billing platforms ( Epic , Athenahealth , AdvancedMD , or equivalent) and clearinghouse tools.
- Exceptional written and verbal English communication skills.
- High attention to detail with the ability to identify billing errors and compliance issues in AI-generated outputs .
Preferred
- CPC , CCS , CHFP , or CRCR certification.
- Experience with automated billing platforms and RCM technology implementations.
- Background in multi-specialty physician group, hospital, or health system billing operations.
- Familiarity with AI tools and comfort evaluating AI-generated billing content .
- Experience with payer contract interpretation and billing compliance program management.
Application Process (Takes 20–30 mins to complete)
- Upload resume
- AI interview based on your resume
- Submit form
Resources & Support
- For details about the interview process and platform information, please check:
- For any help or support, reach out to:
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.
Originally posted on Himalayas