Remote Denials & Appeals Manager (AI-Driven)

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

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.