We are looking for Medical Billing Manager candidates for a project delivered through Mercor.
What you'll do
- 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 and 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.
- Manage billing staff workload, productivity, and quality performance metrics.
- Develop and maintain billing SOPs and payer-specific billing reference guides.
- Annotate AI outputs and provide structured feedback to support AI training datasets.
What you need
- 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.
Nice to have
- CPC, CCS, CHFP, or CRCR certification.
- Experience with automated billing platforms and RCM technology implementations.
- Background in multi-speciality 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.
Who you work with
Project and contracting process: Mercor. Applications continue on the provider's website.