Underpayment Recovery Expert - Remote | Upto $85/hr

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .

Position: Underpayment & Managed-care Contract Specialist

Type: Contract

Compensation: $85/hour

Location: Remote

Role Responsibilities

• Identify, analyze, 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 modeling 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 .

Qualifications

Must-Have

• 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, percent-of-billed charges, and fee schedule reimbursement. • Strong experience with contract modeling, payment reconciliation, and payer dispute resolution. • Familiarity with managed care contract management systems and payment variance detection tools. • Proficiency with Excel-based financial analysis and revenue cycle analytics platforms. • Exceptional written and verbal English communication skills. • High attention to detail with the ability to identify payment discrepancies in complex contract structures and AI-generated outputs.

Preferred

• CHFP , CRCR , or managed care contracting certification. • Experience with contract management software (e.g., Experian Health , Recondo , or similar). • Background in hospital, health system, or large physician group underpayment recovery operations. • Familiarity with AI tools and comfort evaluating AI-generated payment variance content. • Experience negotiating payer contracts and presenting underpayment analysis to executive leadership.