Claim examiner • riverside ca
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 e... Show more
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 e... Show more
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 improvemen... Show more
You May Be a Great Fit as a Multiline Representative at.You’re the person people call first when life goes sideways.You genuinely care about your community.You’re a natural relationship-builder.You... Show more
Local CDL-A Intermodal Driver | 100% Home Daily NIGHTS.No-Touch Freight, Big Hours & Daily Home Time.Looking to pull local containers and sleep in your own bed after every single shift? W... Show more
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 ... Show more
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Billing and Claims Managers to support the evaluation of AI too... Show more
Local CDL-A Intermodal Driver | 100% Home Daily! NIGHTS 7 to 9pm start times!.We have immediate openings on our dedicated intermodal fleet.Handle container transport across the metro area with a so... Show more
By joining Sedgwick, you'll be part of something truly meaningful.It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your c... Show more
The Claims Specialist is responsible for evaluating, processing, and managing liability, property, auto, general liability claims, and employment claims in compliance with state regulations; docume... Show more
Are you a self-starter? Are you tired of being locked down in an office all day? Do you crave the flexibility to manage, plan and execute your day-to-day workload? If so, then this opportunity is t... Show more
The Deduction Analyst is responsible for reviewing, researching, and resolving customer shortage and overage deduction claims in a timely and accurate manner.This role partners closely with Custome... Show more
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced A/R Follow-Up Managers to evaluate AI tools designed to automat... Show more
Role Overview** - Mercor is seeking senior intellectual property professionals to build evaluation tasks for AI systems operating in patent prosecution, licensing, and IP enforcement contexts.The w... Show more
Put your Insurance Experience to work – FROM HOME!.Our unique platform provides you with.WHAT YOU’LL LOVE ABOUT WAHVE.We created a welcoming place to work with friendly and professional... Show more
Role Overview** - Mercor is seeking senior intellectual property professionals to build evaluation tasks for AI systems operating in patent prosecution, licensing, and IP enforcement contexts.The w... Show more
Collections Specialist Remote Job Duties: • Meet the defined productivity metric of a minimum of 30 daily claim touch... Show more
Claims Team Lead - Workers Compensation.By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the... Show more
Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the career for you!... Show more
As Financial Representative – State Farm Agent Team Member with David Ceballos - State Farm Agent, you equip our agency to continually achieve its goals.You empower our agency by implementing and s... Show more
The average salary range is between $ 40,387 and $ 91,289 year , with the average salary hovering around $ 56,396 year .
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.
