Seeking experienced patient financial services leaders to evaluate healthcare AI systems, improve self-pay collections, optimize patient payment plans, enhance financial engagement, and maximize revenue recovery while maintaining compliance and patient satisfaction.
Denials Management & Appeals Manager
United States
$93 – $93/hr
June 24, 2026
Job description
Role Overview
Mercor is partnering with a leading AI research laboratory to improve next-generation AI systems used in healthcare denials management, appeals processing, and revenue cycle optimization.
The organization is seeking experienced Denials Management and Appeals Managers to evaluate and improve AI tools designed to automate denial prevention, root cause analysis, appeal generation, and revenue recovery workflows.
Responsibilities
Denials Management Leadership
- Lead denials management and appeals operations
- Oversee identification, categorization, tracking, and resolution of claim denials
- Support denial reduction and revenue recovery initiatives
AI Evaluation & Quality Review
- Evaluate AI-generated appeal letters, denial root cause analyses, denial prevention recommendations, and revenue recovery strategies
- Assess outputs for accuracy, compliance, clinical validity, and appeal effectiveness
- Annotate AI outputs and provide structured feedback for AI training datasets
Denial Analytics
- Analyze denial trends by payer, CARC codes, RARC codes, denial categories, and service lines
Appeals Management
- Develop and manage clinical appeals, technical appeals, medical necessity appeals, and external review submissions
Requirements
- 5+ years of experience in Denials Management, Appeals Management, or Revenue Cycle Operations
- Minimum 2 years in a management role
- Deep knowledge of CARC codes, RARC codes, payer denial patterns, and denial prevention strategies
- Strong understanding of clinical appeals, technical appeals, and peer-to-peer reviews
Preferred Qualifications
- CPC, CCS, CRCR, or CHFP certification
- Experience with Waystar, Experian Health, Nthrive, or AI-assisted denial management systems
Contract & Payment Terms
- Independent contractor engagement · Fully remote · Flexible schedule
- Weekly payments through Stripe or Wise
- US work authorization required · No visa sponsorship
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