Insurance Verification & Benefit Manager

Insurance Verification & Benefit Manager

$105 per hour

Hourly contract Remote

New opportunity

Early applicant

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Location Requirements

United States

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Insurance Verification and Eligibility & Benefits Managers to evaluate AI tools designed to automate front-end revenue cycle operations. Your deep expertise in payer systems, EDI transactions, and eligibility workflows will directly inform AI models that drive accuracy and efficiency in insurance verification processes.

Responsibilities

• Oversee insurance verification, eligibility determination, and benefits investigation workflows across commercial, Medicare, Medicaid, and managed care payers.
• Verify patient insurance coverage using payer portals, clearinghouses, and EDI 270/271 real-time eligibility transactions.
• Identify and resolve coordination of benefits issues, coverage gaps, and eligibility discrepancies prior to service delivery.
• Evaluate and annotate AI-generated eligibility verification outputs for accuracy, completeness, and payer compliance.
• Develop and document SOPs for eligibility and benefits verification workflows.
• Monitor KPIs including verification accuracy rates, front-end denial rates related to eligibility, and turnaround times.
• Ensure compliance with payer-specific requirements, CMS guidelines, and HIPAA regulations.
• Identify process gaps and recommend workflow improvements to reduce eligibility-related claim denials.
• Provide structured feedback and annotations to support AI training datasets.

Requirements

• 5+ years of experience in insurance verification, eligibility and benefits management, or front-end revenue cycle operations, with at least 2 years in a management role.
• Expert knowledge of EDI 270/271 transactions, payer portal navigation, and real-time eligibility tools.
• Strong familiarity with Medicare, Medicaid, and commercial payer eligibility requirements and benefit structures.
• Proficiency with Epic, Cerner, Meditech, or equivalent EHR platforms.
• Experience with clearinghouse platforms such as Availity, Change Healthcare, or similar.
• Exceptional written and verbal English communication skills.
• High attention to detail with the ability to identify subtle discrepancies in coverage data.

Preferred Qualifications

• CHAM, CHAA, or equivalent front-end revenue cycle certification.
• Experience with automated eligibility verification tools and RPA solutions.
• Background in denial root cause analysis related to eligibility and coverage errors.
• Familiarity with AI tools and comfort evaluating AI-generated healthcare content.
• Experience presenting eligibility performance data to senior leadership.

Why Join?

• Contribute to the development of frontier AI systems in healthcare.
• Collaborate with a world-class AI research organisation.
• Gain exposure to cutting-edge AI workflows in healthcare revenue cycle management.
• Opportunity to work on high-impact projects shaping the future of healthcare AI.

We consider all qualified applicants without regard to legally protected characteristics and provide reasonable accommodations upon request.

Contract and Payment Terms

• You will be engaged as an independent contractor.
• This is a fully remote role that can be completed on your own schedule.
• Projects can be extended, shortened, or concluded early depending on needs and performance.
• Your work at Mercor will not involve access to confidential or proprietary information from any employer, client, or institution.
• Payments are weekly on Stripe or Wise based on services rendered.
• Please note: We are unable to support H1-B or STEM OPT candidates at this time.

About Mercor

Mercor partners with leading AI labs and enterprises to train frontier models using human expertise. You will work on projects that focus on training and enhancing AI systems. You will be paid competitively, collaborate with leading researchers, and help shape the next generation of AI systems in your area of expertise.

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