Talent.com
Mercor
Remote Denials Management & Appeals Manager - AI Trainer ($93-$93 per hour)Mercor • Chino, California, US
No longer accepting applications
Remote Denials Management & Appeals Manager - AI Trainer ($93-$93 per hour)

Remote Denials Management & Appeals Manager - AI Trainer ($93-$93 per hour)

Mercor • Chino, California, US
30+ days ago
Salary
$93.00 hourly
Job type
  • Full-time
  • Remote
Job description
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Denials Management and Appeals Managers to evaluate AI tools designed to automate denial prevention, appeal writing, and root cause analysis workflows. Your expertise in payer denial patterns, clinical and technical appeals, and denial management analytics will directly inform AI systems that reduce denial rates and maximise revenue recovery. **Responsibilities** - Lead denials management and appeals operations, overseeing the identification, categorisation, and resolution of claim denials. - Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness. - Analyse denial trends by payer, denial code (CARC/RARC), and denial category to identify systemic root causes. - Develop and manage clinical and technical appeal strategies across multiple payer types. - Coordinate with clinical, coding, billing, and compliance teams to implement denial prevention initiatives. - Monitor denial management KPIs including denial rates, appeal overturn rates, revenue recovery, and days in A/R. - Manage the appeals calendar to ensure timely submission within payer and regulatory deadlines. - Ensure compliance with payer appeal requirements, CMS regulations, and timely filing deadlines. - Annotate AI outputs and provide structured feedback to support AI training datasets. **Requirements** - 5+ years of experience in denials management, appeals, or revenue cycle operations, with at least 2 years in a management role. - Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across commercial, Medicare, and Medicaid payers. - Strong understanding of clinical and technical appeal processes including peer-to-peer reviews and external reviews. - Experience with denial analytics platforms and revenue cycle reporting tools. - Proficiency with EHR systems and billing platforms. - Exceptional written and verbal English communication skills. - High attention to detail with the ability to evaluate appeal quality and identify errors in AI-generated denial management content. **Preferred Qualifications** - CPC, CCS, CRCR, or CHFP certification. - Experience with AI-assisted denial management platforms (e.g., Waystar, Experian Health, Nthrive). - Background in complex clinical appeals including medical necessity, experimental/investigational, and level of care denials. - Familiarity with AI tools and comfort evaluating AI-generated appeal and denial content. - Experience presenting denial management performance to revenue cycle 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 denials management and revenue cycle. - Opportunity to work on high-impact projects shaping the future of healthcare AI.
Create a job alert for this search

Remote Denials Management & Appeals Manager - AI Trainer ($93-$93 per hour) • Chino, California, US

Similar jobs

Online Survey Participant: Work Remote and Earn Up To $25 Per Survey

Earn HausPhelan, CA, US
Remote
Full-time +1

Looking for people to participate in taking online surveys for Fortune 500 brands.All you need to do is complete online surveys by sharing your opinion.You will help influence brand decisions on se... Show more

 • Promoted

Complete Online Surveys For Cash (Up to $25/per)

Earn HausPhelan, CA, US
Full-time +1

Looking for people to participate in taking online surveys for Fortune 500 brands.All you need to do is complete online surveys by sharing your opinion.You will help influence brand decisions on se... Show more

 • Promoted

Manager, Clinical Research Specialist Training THV AR (Remote US)

Edwards Lifesciences CorpIrvine, CA, United States
Full-time

Imagine how your ideas and expertise can change a patient's life.We generate extensive clinical evidence to demonstrate the effectiveness and safety of our innovations and how our products transfor... Show more

 • Promoted

Become a Surrogate – Give the Miracle of Life & Earn Up to $115,000 from Home!

Giving Tree SurrogacyPhelan, CA, US
Full-time +1

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate.In this role, you will be instrumental in supporting indi... Show more

 • Promoted

Remote Product Tester - Flexible Studies

BuzzTestersPinon Hills, CA
Remote
Full-time

Earn up to $400/week, depending on the number and type of studies you complete.Share honest feedback on products and services from independent brands.Assignments include short online surveys (10–20... Show more

 • Promoted

Clinical Director, BCBA

Accel TherapiesWrightwood, CA, US
Full-time

Tahoma, Geneva, sans-serif;"><span style="font-variant:normal;white-space:pre-wrap;"><span style="color:#000000;"><span style="font-weight:700;"><span style="font-style:norm... Show more

 • Promoted

Become a Surrogate: Give the Gift of Life & Earn Up to $115,000 from Home!

Giving Tree SurrogacyWrightwood, CA, US
Full-time +1

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate.In this role, you will be instrumental in supporting indi... Show more

 • Promoted

Become a Surrogate, give the miracle of life, and earn up to $115,000 from home!

Giving Tree SurrogacyPinon Hills, CA, US
Full-time +1

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate.In this role, you will be instrumental in supporting indi... Show more

 • Promoted

Survey Taker: Earn up to $25 per survey (Remote)

Earn HausPhelan, CA, US
Remote
Full-time +1

Looking for people to participate in taking online surveys for Fortune 500 brands.All you need to do is complete online surveys by sharing your opinion.You will help influence brand decisions on se... Show more

 • Promoted

Give the Gift of Life – Surrogates Needed, Earn Up to $115,000!

Giving Tree SurrogacyPhelan, CA, US
Full-time +1

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate.In this role, you will be instrumental in supporting indi... Show more

 • Promoted

Make Miracles Happen: Become a Surrogate & Earn Up to $115,000 from Home!

Giving Tree SurrogacyPhelan, CA, US
Full-time +1

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate.In this role, you will be instrumental in supporting indi... Show more

 • Promoted

Market Research Associate - No Experience

Clubshop | USPhelan, California
Full-time

Discover The System Surveoo That’s Helping Newbies Earn Daily.Turn your free time into daily earnings by answering simple surveys.No product or tech skills needed.Join For Free And Start Earn... Show more

Remote Job $790/wk - Hiring Focus Group Panelists

MaxionPhelan, CA, US
Remote
Full-time +2

Want to make extra money on YOUR schedule? Join our exclusive list of research study participants and .Perfect for anyone seeking remote, part-time, or temporary work, these opportunities require .... Show more

 • Promoted

Earn Cash From Taking Surveys Online

Earn HausPhelan, CA, US
Full-time +1

Looking for people to participate in taking online surveys for Fortune 500 brands.All you need to do is complete online surveys by sharing your opinion.You will help influence brand decisions on se... Show more

 • Promoted

Conversational AI and Agentic AI - Manager

PwC (US)Irvine, CA, United States
Full-time

Conversational AI and Agentic AI - Manager.As a Conversational AI and Agentic AI - Manager, you will lead the charge in developing innovative user interaction solutions within our Advisory practice... Show more

 • Promoted

Flexible remote AI work. Your schedule. Paid weekly, straight to your bank account.

Meridian.aiPhelan, CA, US
Remote
Full-time

Review and label digital content including text, images, and documents.Every task you complete helps improve how technology interprets information and performs in practical settings.Detail-oriented... Show more

 • Promoted

Manager, Clinical Research Specialist Training THV AR (Remote US)

Edwards LifesciencesIrvine, CA, United States
Remote
Full-time

Clinical Training Program Leader.Imagine how your ideas and expertise can change a patient's life.We generate extensive clinical evidence to demonstrate the effectiveness and safety of our innovati... Show more

 • Promoted

Caboodle ETL Developer I, II Epic-(Open to experienced remote in ID, NE, MO, OK, TX)

PIH HealthLytle Creek, CA, United States
Remote
Full-time

The Caboodle ETL Developer develops custom import packages to move additional data sets into the Caboodle database.This role may not be required depending on how you plan to use Caboodle at your or... Show more

 • Promoted

Earn Side Money at Home Testing Products

Product Review JobsLYTLE CREEK, CA, United States
Full-time

Compensation: Varies per assignment.Location: Remote (USA) Company: ProductReviewJobs Thank you for your interest in becoming a Paid Product Tester.This opportunity is for completing market res... Show more

 • Promoted

Paid Product Tester

Product Review JobsMT BALDY, CA, United States
Full-time

Compensation: Varies per assignment.Location: Remote (USA) Company: ProductReviewJobs Thank you for your interest in becoming a Paid Product Tester.This opportunity is for completing market res... Show more