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# Denials Management & Appeals Manager (Train AI Models Part Time

- **Company:** Mercor, Inc.
- **Location:** United States
- **Experience:** Experienced
- **Contract:** Permanent contract
- **Skills:** Artificial Intelligence, EHR Systems, Tools for Reporting
- **Published:** July 18, 2026
- **Apply:** https://find.jobs/jobs-near-me/apply/ats-redirect/?id=2878630418-2

## About the Role

5+ years of experience in denials management, appeals, or revenue cycle operations, with at least 2 years in a management role.

 - Deep knowledge of CARC/RARC denial codes, payer denial patterns, and appeal strategies across commercial, Medicare, and Medicaid payers.

 - Strong understanding of clinical and technical appeal processes including peer-to-peer reviews and external reviews.

 - Experience with denial analytics platforms and revenue cycle reporting tools.

 - Proficiency with EHR systems and billing platforms.

 - Exceptional written and verbal English communication skills.

 - High attention to detail with the ability to evaluate appeal quality and identify errors in AI-generated denial management content.

Preferred Qualifications

 - CPC, CCS, CRCR, or CHFP certification.

 - Experience with AI-assisted denial management platforms (e.g., Waystar, Experian Health, Nthrive).

 - Background in complex clinical appeals including medical necessity, experimental/investigational, and level of care denials.

 - Familiarity with AI tools and comfort evaluating AI-generated appeal and denial content.

 - Experience presenting denial management performance to revenue cycle leadership.

## Description

Lead denials management and appeals operations, overseeing the identification, categorisation, and resolution of claim denials.

 - Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness.

 - Analyse denial trends by payer, denial code (CARC/RARC), and denial category to identify systemic root causes.

 - Develop and manage clinical and technical appeal strategies across multiple payer types.

 - Coordinate with clinical, coding, billing, and compliance teams to implement denial prevention initiatives.

 - Monitor denial management KPIs including denial rates, appeal overturn rates, revenue recovery, and days in A/R.

 - Manage the appeals calendar to ensure timely submission within payer and regulatory deadlines.

 - Ensure compliance with payer appeal requirements, CMS regulations, and timely filing deadlines.

 - Annotate AI outputs and provide structured feedback to support AI training datasets.


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