Description review
Claims Processing Manager - Fully Remote | Upto $80/hr
mercor · United States · back to the listing
HR standards
78/100
solid
Title ↔ description
47/100
poor
Reads as
Operations Manager
87% confident
What this role officially is
operations manager — ESCO, the EU occupation classification
Operations managers plan, oversee and coordinate the daily operations of production of goods and provision of services. They also formulate and implement company policies and plan the use of human resources and materials.
Also known as: division operations manager, operations administrator, operations supervisor, operations general manager, operations director, business operations manager
How others title the same work
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What the listing never says
- 24 bullet points. Long requirement lists deter qualified candidates, who read them as hard gates. Scope clarity
- No pay range published. Candidates cannot tell whether applying is worth their time. Pay transparency
The listing, marked up
Nothing in the wording of this listing tripped a check. The scores above still judge how complete and coherent it is.
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
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