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Underpayment Recovery Expert - Remote | Upto $85/hr

Mercor

Job Description

Job Description

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: Underpayment & Managed-care Contract Specialist
Type: Contract
Compensation: $85/hour
Location: Remote

Role Responsibilities

  • Identify, analyze, and recover underpayments and payment variances across commercial, Medicare Advantage , and Medicaid managed care payer contracts.
  • Evaluate AI-generated underpayment detection alerts, contract compliance outputs, and payment variance analyses for accuracy.
  • Interpret payer contract terms including fee schedules, carve-outs, outlier provisions, and payment methodologies to validate claim payments.
  • Conduct contract modeling and payment reconciliation to identify systematic underpayment patterns.
  • Develop and submit underpayment claims and recovery correspondence to payers.
  • Collaborate with managed care contracting teams to identify contract language gaps and renegotiation opportunities.
  • Monitor underpayment recovery KPIs including identified underpayment dollars, recovery rates, and payer response rates.
  • Ensure compliance with payer contract terms, HIPAA , and timely filing requirements for underpayment recovery.
  • Annotate AI outputs and provide structured feedback to support AI training datasets .

Qualifications

Must-Have

  • 5+ years of experience in underpayment recovery, payment variance analysis, or managed care contracting, with demonstrated expertise in contract interpretation.
  • Deep knowledge of payer payment methodologies including DRG-based , per diem, percent-of-billed charges, and fee schedule reimbursement.
  • Strong experience with contract modeling, payment reconciliation, and payer dispute resolution.
  • Familiarity with managed care contract management systems and payment variance detection tools.
  • Proficiency with Excel-based financial analysis and revenue cycle analytics platforms.
  • Exceptional written and verbal English communication skills.
  • High attention to detail with the ability to identify payment discrepancies in complex contract structures and AI-generated outputs.

Preferred

  • CHFP , CRCR , or managed care contracting certification.
  • Experience with contract management software (e.g., Experian Health , Recondo , or similar).
  • Background in hospital, health system, or large physician group underpayment recovery operations.
  • Familiarity with AI tools and comfort evaluating AI-generated payment variance content.
  • Experience negotiating payer contracts and presenting underpayment analysis to executive leadership.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.

Vacancy posted more than 2 months ago

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