Underpayment & Managed-care Contract Specialist
Mercor • Remote
Education
Any
Type
hourly
Pay Rate
$85/hr
Listed
32d 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 Underpayment and Managed Care Contract Specialists to evaluate AI tools designed to detect payment variances and automate contract compliance monitoring. Your expertise in payer contract interpretation, payment variance analysis, and underpayment recovery will help AI systems optimise net revenue and identify systematic underpayments.
Responsibilities
Identify, analyse, 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 modelling 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.
Requirements
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, per cent-of-billed charges, and fee schedule reimbursement.
Strong experience with contract modelling, 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 Qualifications
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.
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 managed care contracting and the revenue cycle.
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 Legal
Eligible Languages
Fluent proficiency in English
Key Responsibilities
- Identify, analyse, 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 modelling and payment reconciliation to identify systematic underpayment patterns.
Why This Role
No office, no fixed hours, no relocation. This Underpayment & Managed-care Contract Specialist role pays $85/hr fully remote, giving you access to Legal work that would otherwise be limited to a handful of major cities.
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Frequently Asked Questions
Is Mercor for freelancers or full-time contractors?
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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.
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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 Legal work look like for a Underpayment & Managed-care Contract Specialist?
Tasks here are scoped to Legal, not generic labeling. As a Underpayment & Managed-care Contract Specialist, expect to draw on real domain judgment (evaluating outputs, correcting errors, or providing expert reasoning specific to Legal) rather than following a one-size-fits-all rubric. If you don't have hands-on Legal 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?
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