Insurance Verification Specialist Remote

Mercor
Part time
Software Development
Canada
Hiring from: Canada
Company Introduction

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.

Role Overview

  • Position: Contractor – Contract, Remote
  • Commitment: ~20-30 hours/week
  • Support an AI lab in building automation tools for payer communication. Create high-quality benefits investigation call scripts for insurance payers.

Responsibilities

  • Develop and refine structured phone call scripts for collecting eligibility and benefits details for specialty medications.
  • Translate payer requirements and notes into clear, natural-language questions for accurate and auditable responses.
  • Incorporate payer-specific nuances, such as medical vs. pharmacy benefits, prior authorization rules, and specialty distribution pathways.
  • Continuously improve scripts based on feedback from QA and real-world payer interactions.
  • Maintain consistency, accuracy, and compliance across all documentation.

Requirements / Qualifications

Must-Have Qualifications

  • Background in specialty pharmacy operations, payer communications, or benefits investigation.
  • Strong understanding of insurance concepts for specialty medications, including coverage restrictions, NDC, J-codes, HCPCS, and ICD-10.
  • Proven ability to write precise, conversational scripts for extracting complete payer information.
  • Excellent written communication and documentation skills with strong attention to detail.

Preferred Qualifications

  • Prior experience conducting payer calls or working in benefits verification is a plus.

Engagement Details

  • Contract Type: Contractor (Independent)
  • Location: Remote
  • Commitment: ~20-30 hours/week

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/welcome
  • For any help or support, reach out to: [email protected]

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

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