Claims Processing Manager - Fully Remote | Upto $80/hr
关于工作的职位，默科尔将精英创意和技术人才与领先的人工智能研究实验室联系起来。总部位于旧金山，我们的投资者包括 Benchmark,General Catalyst,Peter Thiel,Adam D'Angelo,Larry Summers 和 Jack Dorsey.职位：医疗 facturation manager 类型：合同赔偿：80美元/小时位置：远程角色责任 ·监督端到端医疗账单和索赔提交操作在专业费用和/或设施支付环境中。·评估人工智能生成的收费输出，要求修改和编码验证以准确性和付款人遵守。· 管理索赔提交工作流程，包括电子索赔生成，清算室编辑和付款人特定的发票要求。·监测清洁的索赔率，拒绝率和第一次通过接受率。制定改进策略。·与编码，CDI 和收藏团队协调解决账单编辑和申请拒绝情况。·确保遵守 CMS 支付指南，HIPAA 837交易标准以及付款人具体的账单规则。· 注册 AI 输出并提供结构化反以支持人工智能培训数据集。资格必须有5年以上在医疗费用和索赔管理方面的经验，至少2年在一个角色中管理。· 专业费用 (CMS-1500/837P) 和/或设施 (UB-04/837I) 的结算要求的深入知识。· HIPAA 837交易标准，清算室运营和付款人特定的结算规则方面的专业知识。· 强有了解医疗保险，医疗补助和商业付款人结算要求。·熟练使用结算平台 （Epic,Athenahealth,AdvancedMD 或相等）和清算室工具。· 卓越的书面和口头英语沟通技能。· 高重视细节错误的能力识别结算和符合 AI 生成输出中的问题。首选 · CPC,CCS,CHFP 或 CRCR 认证。· 经验自动化发票平台和 RCM 技术实施。· 多专业医生组，医院或卫生系统的发票操作背景。·熟悉人工智能工具以及评估人工智能生成的发票内容的舒适性。· 经历付款人合同解释和支票遵守计划管理。申请过程 （需要20~30分钟才能完成）· 上传简历 ·基于简历的人工智能面试 ·提交表资源 & 支持 ·有关采访流程和平台信息详情
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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: Medical Billing Manager
Type:Contract
Compensation:$80/hour
Location:Remote
Role Responsibilities
- Oversee end-to-end medical billing and claims submission operations across professional fee and/or facility billing environments.
- Evaluate AI-generated billing outputs, claim edits, and coding validations for accuracy and payer compliance.
- Manage claims submission workflows including electronic claim generation, clearinghouse edits, and payer-specific billing requirements.
- Monitor clean claim rates, rejection rates, and first-pass acceptance rates. Develop improvement strategies.
- Coordinate with coding, CDI, and collections teams to resolve billing edits and claim rejections.
- Ensure compliance with CMS billing guidelines, HIPAA 837 transaction standards, and payer-specific billing rules.
- Annotate AI outputs and provide structured feedback to support AI training datasets.
Qualifications
Must-Have
- 5+ years of experience in medical billing and claims management, with at least 2 years in a management role.
- Deep knowledge of professional fee (CMS-1500/837P) and/or facility (UB-04/837I) billing requirements.
- Expertise in HIPAA 837 transaction standards, clearinghouse operations, and payer-specific billing rules.
- Strong understanding of Medicare, Medicaid, and commercial payer billing requirements.
- Proficiency with billing platforms (Epic, Athenahealth, AdvancedMD, or equivalent) and clearinghouse tools.
- Exceptional written and verbal English communication skills.
- High attention to detail with the ability to identify billing errors and compliance issues in AI-generated outputs.
Preferred
- CPC, CCS, CHFP, or CRCR certification.
- Experience with automated billing platforms and RCM technology implementations.
- Background in multi-specialty physician group, hospital, or health system billing operations.
- Familiarity with AI tools and comfort evaluating AI-generated billing content.
- Experience with payer contract interpretation and billing compliance program management.
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:
- For any help or support, reach out to:
PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.
Originally posted on Himalayas