Medical Billing Manager

About this role

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Billing and Claims Managers to support the evaluation of AI tools designed to automate and improve medical billing and claims submission workflows. Your expertise in claims processing, payer requirements, EDI transactions, and billing compliance will directly inform AI systems that improve first-pass claim acceptance rates and accelerate revenue cycle performance. **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 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. **Requirements** - 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