Underpayment & Managed-care Contract Specialist

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 Underpayment and Managed Care Contract Specialists to evaluate AI tools designed to detect payment variances and automate contract compliance monitoring. Your expertise in payer contract interpretation, payment variance analysis, and underpayment recovery will help AI systems optimise net revenue and identify systematic underpayments. **Responsibilities** - Identify, analyse, and recover underpayments and payment variances across commercial, Medicare Advantage, and Medicaid managed care payer contracts. - Evaluate AI-generated underpayment detection alerts, contract compliance outputs, and payment variance analyses for accuracy. - Interpret payer contract terms including fee schedules, carve-outs, outlier provisions, and payment methodologies to validate claim payments. - Conduct contract modelling and payment reconciliation to identify systematic underpayment patterns. - Develop and submit underpayment claims and recovery correspondence to payers. - Collaborate with managed care contracting teams to identify contract language gaps and renegotiation opportunities. - Monitor underpayment recovery KPIs including identified underpayment dollars, recovery rates, and payer response rates. - Ensure compliance with payer contract terms, HIPAA, and timely filing requirements for underpayment recovery. - Annotate AI outputs and provide structured feedback to support AI training datasets. **Requirements** - 5+ years of experience in underpayment recovery, payment variance analysis, or managed care contracting, with demonstrated expertise in contract interpretation. - Deep knowledge of payer payment methodologies including DRG-based, per diem, per cent-of-billed charges, and fee schedule reimbursement. - Strong experience with contract modelling, payment reconciliation, and payer disput