APPEALS MANAGER - FULLY REMOTE | UPTO $93/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: Denials Management & Appeals Manager Type: Contract Compensation: $70–$93/hour Location: Remote Role Responsibilities • Lead denials management and appeals operations. Oversee identification, categorization, and resolution of claim denials. • Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness. • Analyze denial trends by payer, denial code ( CARC/RARC ), and denial category to identify systemic root causes. • Develop and manage clinical and technical appeal strategies across multiple payer types. • Coordinate with clinical, coding, billing, and compliance teams to implement denial prevention initiatives. • Monitor denial management KPIs including denial rates, appeal overturn rates, revenue recovery, and days in A/R. • Ensure compliance with payer appeal requirements, CMS regulations, and timely filing deadlines. • Annotate AI outputs and provide structured feedback to support AI training datasets . Qualifications Must-Have • 5+ years of experience in denials management, appeals, or revenue cycle operations, with at least 2 years in a management role. • Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across commercial, Medicare, and Medicaid payers. • Strong understanding of clinical and technical appeal processes including peer-to-peer reviews and external reviews. • Experience with denial analytics platforms and revenue cycle reporting tools. • Proficiency with EHR systems and billing platforms. • Exceptional written and verbal English communication skills. • High attention to detail with the ability to evaluate appeal quality and identify errors in AI-generated denial management content. Preferred • CPC , CCS , CRCR , or CHFP certification . • Experience with AI-assisted denial management platforms (e.g., Waystar , Experian Health , Nthrive ). • Background in complex clinical appeals including medical necessity, experimental/investigational, and level of care denials. • Familiarity with AI tools and comfort evaluating AI-generated appeal and denial content. • Experience presenting denial management performance to revenue cycle leadership. 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: https://talent.docs.mercor.com/welcome • For any help or support, reach out to: support@mercor.com PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.