Claim examiner Jobs in El Cajon, CA

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Patient Access leaders to support the evaluation and improvement of AI tools designed for healthcare revenue cycle workflows. This is an opportunity to apply your expertise in patient registration, pre-registration, scheduling, and intake coordination to help shape AI systems that will transform front-end healthcare operations. **Responsibilities** - Lead end-to-end patient access operations including pre-registration, registration, scheduling, and intake workflows across inpatient and outpatient settings. - Evaluate AI-generated outputs related to patient access processes, identifying errors and providing structured, actionable feedback. - Develop and enforce policies and procedures for registration accuracy, demographic capture, and point-of-service collections. - Monitor KPIs including registration error rates, pre-registration completion rates, insurance verification accuracy, and front-end denial rates. - Ensure clean claim submission from point of entry by identifying and resolving front-end deficiencies. - Collaborate with billing, clinical, and IT teams to streamline patient access workflows and reduce downstream claim errors. - Train and mentor staff on registration best practices, compliance requirements, and system usage. - Ensure compliance with HIPAA, CMS guidelines, and payer-specific requirements at the point of service. - Document observations, annotate AI outputs, and provide structured feedback to support AI training datasets. **Requirements** - 5+ years of experience in patient access, patient registration, or front-end revenue cycle management, with at least 2 years in a manager or director-level role. - Deep knowledge of pre-registration, insurance verification, scheduling intake, and point-of-service collections. - Strong understanding of HIPAA, CMS regulations, and commercial and government payer requirements. - Proficiency with Epic, Cerner, Meditech, or similar EHR and registration systems. - Exceptional written and verbal English communication skills. - High attention to detail and ability to identify inconsistencies in workflows, data, or AI-generated outputs. - Comfortable working independently in a fully remote environment. - Strong organisational skills with the ability to manage multiple priorities simultaneously. **Preferred Qualifications** - NAHAM Certified Healthcare Access Manager (CHAM) or Certified Healthcare Access Associate (CHAA) credential. - Experience with denial prevention strategies at the point of registration. - Familiarity with AI tools such as ChatGPT, Claude, or similar systems. - Background in health system, hospital, or large physician group settings. - Experience developing SOPs and training materials for patient access teams. **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.