Benefits Manager - Fully Remote | Upto $105/hr

mercor; United States; Remote; USD 138,000 - 152,000; Part time

Job summary

Mercor seeks an Insurance Verification & Benefit Manager to lead verification and benefits workflows remotely for a contract engagement. The role focuses on across-payer eligibility, COB resolution, and accuracy checks using real-time tools.

You will optimize SOPs, monitor KPIs, and drive high-quality eligibility outcomes with a distributed team and healthcare partners.

Qualifications

• Minimum 5+ years in insurance verification, eligibility and benefits management; at least 2 years in a leadership role.
• Expert knowledge of EDI 270/271 transactions and payer portals.
• Familiarity with Medicare, Medicaid, and commercial payer eligibility requirements.
• Proficiency with major EHR platforms (Epic, Cerner, Meditech) and clearinghouses such as Availity or Change Healthcare.

Responsibilities

• Oversee insurance verification, eligibility determination, and benefits workflows across payers.
• Verify coverage using payer portals and real-time eligibility tools.
• Identify and resolve coordination of benefits issues and eligibility discrepancies.
• Evaluate AI-generated eligibility outputs for accuracy and payer compliance.
• Develop SOPs for eligibility and benefits verification workflows.

Skills

Insurance verification

Eligibility management

Benefits management

Payer knowledge

Communication

Attention to detail

Leadership

Front-end revenue cycle

English proficiency

Education

CHAM

CHAA

Tools

Epic

Cerner

Meditech

Availity

Change Healthcare

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: Insurance Verification & Benefit Manager

Type: Contract

Compensation: $105/hour

Location: Remote

Role 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.

Qualifications

Must-Have

• 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

• 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.