Appeals Manager - Fully Remote | Upto $93/hr

mercor; United States; Remote; USD 96,000 - 128,000; Part time

Job summary

Mercor is seeking a Denials Management & Appeals Manager to lead denial operations across payer types, including CARC/RARC codes, for a remote contract role. You will drive analytics, oversee strategies, and coordinate with clinical and billing teams to improve revenue cycle performance.

The ideal candidate has 5+ years in denials management, strong English communication, and proven leadership in a fast-paced healthcare environment.

Qualifications

• 5+ years of denials management or revenue cycle experience.
• Management experience with teams and KPIs.
• Deep knowledge of CARC/RARC denial codes.
• Experience with denial analytics and reporting tools.

Responsibilities

• Lead denials management and appeals operations across payer types.
• Evaluate AI-generated appeal letters, denial root cause analyses, and prevention recommendations.
• Analyze denial trends by payer, denial code, and category to identify root causes.
• Develop and manage clinical and technical appeal strategies.
• Coordinate with clinical, coding, billing and compliance teams to implement denial prevention.
• Monitor KPIs including denial rates, appeal overturns, revenue recovery and days in AR.
• Ensure compliance with payer appeal requirements, CMS deadlines, and timely filing.
• Annotate AI outputs and provide structured feedback for AI training datasets.

Skills

Denials management

Revenue cycle

Leadership

Analytical thinking

English communication

Education

CPC, CCS, CRCR, or CHFP certification

Tools

Waystar

Experian Health

Nthrive

EHR systems

Billing platforms

Job description

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: $70–$93/hour Location: Remote

Role Responsibilities

• Lead denials management and appeals operations. Oversee 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, CMS regulations, and timely filing deadlines.
• Annotate AI outputs and provide structured feedback to support AI training datasets .

Qualifications Must-Have

• 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

• 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.