Key Facts

Remote From:

New York (USA)

Category: Insurance Broker

Part time

English

Hard Skills

Utilization Management Regulatory Compliance Online Communication Hiera

Other Skills

•
Analytical Thinking
•
Detail Oriented

Roles & Responsibilities

3+ years of professional experience at a health plan, benefits administrator, TPA, PBM, or managed care organization.
Background in claims processing, medical underwriting, utilization management, benefits administration, or regulatory compliance.
Strong analytical thinking and ability to translate health plan workflows into structured evaluation tasks.

Requirements:

Review and evaluate AI-generated outputs related to plan benefit design, coverage determination, claims adjudication, and medical necessity criteria.
Create realistic scenarios based on health insurance workflows, including prior authorization decisions and regulatory audits.
Annotate, label, and validate data across health insurance use cases, such as ICD coding accuracy and payer policy interpretation.
Provide structured feedback on AI accuracy in federal and state insurance regulations, payer contracting, and industry-specific terminology.

Job description

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: Health Insurance Expert
Type: Contract
Compensation: $1,150–$1,450 per completed task
Location: Remote

Role Responsibilities

Review and evaluate AI-generated outputs related to plan benefit design, coverage determination, claims adjudication, and medical necessity criteria.
Create realistic scenarios based on health insurance workflows, including prior authorization decisions and regulatory audits.
Annotate, label, and validate data across health insurance use cases, such as ICD coding accuracy and payer policy interpretation.
Provide structured feedback on AI accuracy in federal and state insurance regulations, payer contracting, and industry-specific terminology.
Collaborate asynchronously with research teams to refine evaluation frameworks for health insurance AI.

Qualifications

Must-Have

3+ years of professional experience at a health plan, benefits administrator, TPA, PBM, or managed care organization.
Background in claims processing, medical underwriting, utilization management, benefits administration, or regulatory compliance.
Strong analytical thinking and ability to translate health plan workflows into structured evaluation tasks.
Clear written communication and attention to detail.

Preferred

Professional designations such as CEBS, AHIP, HIAA, or Fellow/ASA actuarial credentials.

Compensation & Legal

Task Completion Pay: Competitive and based on task quality.
Performance Bonus: Weekly bonus incentive for top performers.
Hourly Opportunity: Transition to an hourly compensation model for sustained quality and throughput.

Application Process (Takes 20–30 mins to complete)

Upload resume
AI interview based on your resume
Submit form

Resources & Support

For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.

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