Claims Processing Manager - Fully Remote | Upto $80/hr

mercor; United States; Remote; USD 94,000 - 127,000; Part time

Job summary

Mercor is seeking a Medical Billing Manager for a remote contract role. You will oversee end-to-end medical billing and claims management across professional and facility environments, ensuring accuracy and payer compliance.

The role requires 5+ years in medical billing, with at least 2 years in a management position, deep knowledge of CMS-1500/837P and UB-04/837I, HIPAA standards, and proficiency with Epic, Athenahealth, or AdvancedMD.

Qualifications

• 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.

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.

Skills

Medical billing expertise

Healthcare payer rules

CMS-837 knowledge

HIPAA compliance

Education

CPC/CCS/CHFP/CRCR certifications

Tools

Epic

Athenahealth

AdvancedMD

Clearinghouse tools

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: 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.