Insurance Verification & Benefit Manager
Mercor • Remote
Education
Any
Type
hourly
Pay Rate
$105/hr
Listed
36d ago
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About this Role
From the Mercor listing
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.
Requirements
- Must be eligible to work in Remote
- Fluent proficiency in English (Written & Verbal)
- Reliable high-speed internet connection
- Bachelor's degree or equivalent professional experience
- Demonstrated expertise in Business
Eligible Languages
Fluent proficiency in English
Key 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.
Why This Role
Few remote roles pay $105/hr for Business judgment on your own schedule. As a Insurance Verification & Benefit Manager, this is that role: real income, flexible hours, and direct exposure to how AI labs are building the next generation of models.
Skills & Categories
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Frequently Asked Questions
Is Mercor for freelancers or full-time contractors?
Mercor places you with one client for a defined engagement, like 'Python Tutor for 3 months', rather than having you grab small tasks from a shared queue. Most roles function as steady contract work, not one-off gigs.
Does Mercor's application require an on-camera interview?
Yes, every applicant records a video interview with an AI interviewer that asks questions about your resume. Clients review that recording to judge communication skills before matching, so there's no way to apply without going on camera.
Does it cost money to apply to Mercor?
No, applying and joining Mercor is free. Mercor's revenue comes from a fee it charges the client on top of your hourly rate, not from applicants. Treat any request for payment to join as a red flag.
Is AI training work the same as traditional consulting?
No. Instead of client deliverables, you're given complex scenarios to evaluate: grading the AI's logic, correcting its hallucinations, and supplying expert-level reasoning it doesn't have on its own. The job is closer to teaching than consulting.
Why do these AI training roles pay so much?
Because general knowledge isn't what's being tested. The model already knows the basics; what it needs is expertise on edge cases, the rare, difficult, highly technical judgment calls only a senior professional in the field would make correctly.
What does the day-to-day workload look like for elite-expert AI training roles?
Slow and deep, not fast and repetitive. A single task can take 45-60 minutes of researching citations or verifying complex calculations. Quality is what's being measured here, not throughput.
What does Business work look like for a Insurance Verification & Benefit Manager?
Tasks here are scoped to Business, not generic labeling. As a Insurance Verification & Benefit Manager, expect to draw on real domain judgment (evaluating outputs, correcting errors, or providing expert reasoning specific to Business) rather than following a one-size-fits-all rubric. If you don't have hands-on Business background, this is likely not the right listing to start with.
Do I need to be fluent in English?
Yes. This role specifically requires English proficiency. You will likely be evaluated on written fluency during the assessment, not just conversational level. If English is not your first language or you are not professionally fluent, this is not the right role. Filter for your native language to find better-matched listings.
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How soon will I start working after applying to Mercor?
Not immediately. Mercor is a talent marketplace, not a task queue, so applying puts you in a pool of candidates. You start working only once a specific client, like a major AI lab, selects your profile, and that matching process can take weeks.