ELIGIBILITY & BENEFITS MANAGER - REMOTE | UPTO $105/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: Insurance Verification & Benefit Manager Type: Contract Compensation: $105/hour Location: Remote Role 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 . Qualifications Must-Have • 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 • 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. 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.