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# Denials Management Expert - Analytics

- **Company:** Mercor, Inc.
- **Location:** New York, NY, United States (Remote available)
- **Experience:** Experienced
- **Salary:** $145,600.0 - $193,440.0
- **Contract:** Permanent contract
- **Skills:** Artificial Intelligence, Data Analysis, EHR Systems, Tools for Reporting
- **Published:** August 22, 2026
- **Apply:** https://www.careerjet.com/jobad/use72d070861a30c618339e7481b13c919

## About the Role

Must-Have

 * 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

 * 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. Oversee identification, categorization, and resolution of claim denials.
 * Evaluate AI-generated appeal letters, denial root cause analyses, and denial prevention recommendations for accuracy and effectiveness.
 * Analyze 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.
 * Ensure compliance with payer appeal requirements, CMS regulations, and timely filing deadlines.
 * Annotate AI outputs and provide structured feedback to support AI training datasets., PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.


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