About the role
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: Denials Management & Appeals Manager Type:Contract Compensation:$93/hour Location:Remote
Role Responsibilities
- Lead denials management and appeals operations. Oversee the identification, categorization, and resolution of claim denials.
- Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness.
- Analyze 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.
- Ensure compliance with payer appeal requirements,