Actuarial Skills, Adjudication, Analysis Skills, Artificial Intelligence (AI), Benchmarking, Cisco ASA (Adaptive Security Appliance), Claims Processing, Communication Skills, Compensation and Benefits, Data Quality, Detail Oriented, Federal Laws and Regulations, Health Insurance, Health Plan, Insurance, Insurance Regulations, International Classification of Diseases (ICD), Managed Care, Regulations, Regulatory Compliance, Research Laboratory, State Laws and Regulations, Top Sales Rep, Training/Teaching, Underwriting, Use Cases, Utilization Management
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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