Insurance Verification & Benefit Manager
Company: Mercor · Pay: $105/hr · Location: Remote — Global · Type: contractor · Posted: 2026-09-14
The Intersection of Healthcare Revenue Cycle Management and Frontier AI Development
The United States healthcare revenue cycle is one of the most complex, highly regulated, and document-heavy operational structures in modern business. Front-end revenue cycle management—particularly insurance verification, eligibility checks, and benefits coordination—dictates the financial health and operational smoothness of medical providers nationwide. For years, healthcare managers have battled administrative bottlenecks, complex payer portals, and frequent claim denials stemming from minor data discrepancies.
Today, a transformative shift is taking place as leading artificial intelligence labs partner with elite operational leaders to automate and streamline these front-end systems. Artificial intelligence models cannot learn the nuances of commercial, Medicare, and Medicaid payer logic on their own; they require world-class human expertise to train, evaluate, and refine their automated outputs. Platforms like Mercor are spearheading this movement, connecting veteran healthcare professionals with high-compensating consulting roles. The Insurance Verification & Benefit Manager opportunity stands at the forefront of this revolution, offering an elite compensation rate of $105 per hour for specialized remote contract work.
Detailed Job Overview & Core Responsibilities
For revenue cycle directors, eligibility managers, and insurance verification specialists seeking high-yield remote opportunities, this role provides an avenue to leverage years of administrative leadership into high-impact AI training. You will collaborate directly with world-class AI research organizations to evaluate automated tools designed to transform front-end healthcare operations.
Key Responsibilities:
- Workflow Oversight: Manage and review insurance verification, eligibility determination, and benefits investigation workflows across commercial insurance plans, Medicare, Medicaid, and managed care payers.
- Real-Time Eligibility Auditing: Validate patient insurance coverage utilizing advanced payer portals, clearinghouses, and EDI 270/271 real-time eligibility transactions.
- Discrepancy Resolution: Identify and resolve complex coordination of benefits issues, coverage gaps, and eligibility inconsistencies prior to medical service delivery.
- AI Output Evaluation: Evaluate, annotate, and grade AI-generated eligibility verification outputs for strict accuracy, completeness, and regulatory payer compliance.
- Standard Operating Procedures: Develop, document, and standardize comprehensive SOPs for eligibility and benefits verification workflows.
- Performance & KPI Monitoring: Track crucial operational metrics including verification accuracy rates, front-end denial rates related to eligibility, and turnaround times.
- Compliance Assurance: Maintain strict adherence to payer-specific stipulations, Centers for Medicare & Medicaid Services (CMS) guidelines, and HIPAA regulations.
- Root Cause Analysis: Pinpoint process gaps and propose actionable workflow enhancements designed to minimize eligibility-related claim rejections.
Candidate Requirements: Qualifications for Success
Because these cutting-edge AI systems directly impact healthcare administration and financial accuracy, the qualification criteria are tailored for seasoned professionals with extensive domain experience.
- Professional Experience: 5+ years of direct experience in insurance verification, eligibility and benefits management, or front-end revenue cycle operations, with a minimum of 2 years in a management or leadership role.
- Technical Competency: Expert knowledge of EDI 270/271 transactions, clearinghouse platforms (such as Availity or Change Healthcare), and complex payer portal navigation.
- Payer & Regulatory Mastery: Deep familiarity with Medicare, Medicaid, and commercial payer structures, alongside rigid HIPAA compliance frameworks.
- Software Proficiency: Practical experience working with major Electronic Health Record (EHR) platforms including Epic, Cerner, Meditech, or equivalent enterprise systems.
- Communication Skills: Exceptional written and verbal English communication abilities, paired with meticulous attention to detail.
Preferred Qualifications: Professional certifications such as CHAM or CHAA, experience with robotic process automation (RPA) tools, background in denial root cause analysis, and comfort presenting operational performance data to senior executive leadership.
Contract Terms, Flexibility, and Global Payment Infrastructure
One of the primary benefits of partnering with Mercor as an independent contractor is the absolute autonomy and flexibility it provides. Traditional healthcare management roles often require demanding on-site hours, rigid schedules, and heavy administrative overhead. This engagement is designed differently:
- Independent Contractor Freedom: Complete your evaluation projects entirely on your own schedule from any remote location within the United States (please note that H1-B or STEM OPT support is unavailable).
- Dynamic Project Timelines: Assignments scale according to enterprise research needs and your personal performance, offering flexible engagement terms.
- Reliable Weekly Compensation: Earnings are paid out on a weekly basis via secure global financial rails like Stripe and Wise, ensuring prompt and transparent payment for services rendered.
Why This Role Maximizes Your Healthcare Management Expertise
If you have spent years managing billing teams, auditing clearinghouse transactions, and fighting claim denials, your operational intuition is extraordinarily valuable. Traditional healthcare environments rarely compensate administrative experts at elite advisory rates without piling on endless corporate responsibilities. AI training contracts allow you to monetize your hard-earned acumen on a pure advisory and analytical basis.
Furthermore, collaborating with top-tier artificial intelligence laboratories gives you an insider's view of the automation tools that will define the next decade of healthcare administration—all while earning a lucrative $105 per hour.
Take the Next Step in Your Professional Career
High-paying independent contracts with flexible remote hours and exceptional compensation rarely remain open for long, particularly as early applicant interest accelerates. If you possess the required background in insurance verification and revenue cycle management and want to shape the future of healthcare technology, now is the time to apply.
Responsibilities
- Workflow Oversight: Manage and review insurance verification, eligibility determination, and benefits investigation workflows across commercial insurance plans, Medicare, Medicaid, and managed care payers.
- Real-Time Eligibility Auditing: Validate patient insurance coverage utilizing advanced payer portals, clearinghouses, and EDI 270/271 real-time eligibility transactions.
- Discrepancy Resolution: Identify and resolve complex coordination of benefits issues, coverage gaps, and eligibility inconsistencies prior to medical service delivery.
- AI Output Evaluation: Evaluate, annotate, and grade AI-generated eligibility verification outputs for strict accuracy, completeness, and regulatory payer compliance.
- Standard Operating Procedures: Develop, document, and standardize comprehensive SOPs for eligibility and benefits verification workflows.
- Performance & KPI Monitoring: Track crucial operational metrics including verification accuracy rates, front-end denial rates related to eligibility, and turnaround times.
- Compliance Assurance: Maintain strict adherence to payer-specific stipulations, Centers for Medicare & Medicaid Services (CMS) guidelines, and HIPAA regulations.
- Root Cause Analysis: Pinpoint process gaps and propose actionable workflow enhancements designed to minimize eligibility-related claim rejections.
Qualifications
- Professional Experience: 5+ years of direct experience in insurance verification, eligibility and benefits management, or front-end revenue cycle operations, with a minimum of 2 years in a management or leadership role.
- Technical Competency: Expert knowledge of EDI 270/271 transactions, clearinghouse platforms (such as Availity or Change Healthcare), and complex payer portal navigation.
- Payer & Regulatory Mastery: Deep familiarity with Medicare, Medicaid, and commercial payer structures, alongside rigid HIPAA compliance frameworks.
- Software Proficiency: Practical experience working with major Electronic Health Record (EHR) platforms including Epic, Cerner, Meditech, or equivalent enterprise systems.
- Communication Skills: Exceptional written and verbal English communication abilities, paired with meticulous attention to detail.