Role Description - Design questions related to your occupation as a Compensation, Benefits, and Job Analysis Specialist. - Evaluate the accuracy and relevance of AI-generated content in compensation and benefits. - Provide structured feedback to improve AI model outputs and training data quality. - Collaborate with AI research teams to ensure consistency and coverage across datasets. - Work independently and asynchronously to meet project deadlines and enhance model performance. Qualifications - 4+ years full-time work experience in compensation, benefits, and job analysis. - Be based in the US, UK, or Canada. - Access to a desktop or laptop computer (Chromebooks not accepted). Requirements - Hourly contractor compensation: $65–$115/hour. - Commitment: 15+ hours/week. - Application process (takes 20–30 mins to complete): - Upload resume - AI interview based on your resume - Submit form Benefits - Remote work opportunity. - Duration: Through mid 2026. Resources & Support - For details about the interview process and platform information, please check: Interview Process . - For any help or support, reach out to: support@mercor.com . - Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.

Role Description - Design questions related to your occupation as a Dispatcher to enhance AI model training. - Collaborate with AI research teams to improve training data quality and performance. - Work independently and asynchronously to meet project deadlines. - Ensure the use of a desktop or laptop computer for project tasks. Qualifications - 4+ years full-time work experience as a Dispatcher, Except Police, Fire, and Ambulance. - Be based in the US, UK, or Canada. Requirements - At-will contractor to Mercor. - Paid weekly via Stripe Connect based on logged project hours. - Cannot support H1-B or STEM OPT status candidates. Benefits - Compensation: $60–$100/hour. - Duration: 3–4 weeks. - Commitment: 15+ hours/week. Application Process - Upload resume. - AI interview based on your resume. - Submit form. Resources & Support - For details about the interview process and platform information, please check: Interview Process Details . - For any help or support, reach out to: support@mercor.com .

Role Description GDIT is seeking a highly skilled Claims Processing Lead to oversee the adjudication and processing workflows for the World Trade Center (WTC) Health Program. This role is pivotal in ensuring that WTC responders and survivors receive timely and accurate medical benefits. You will lead a team of processors, serve as the primary subject matter expert for complex federal claim regulations, and ensure all activities meet the strict compliance standards of the WTC Health Program. The World Trade Center Health Program is a limited federal health program administered by the National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention in the U.S. Department of Health and Human Services. The Program provides no-cost medical monitoring and treatment for certified WTC-related health conditions to those directly affected by the 9/11 attacks in New York, the Pentagon, and in Shanksville, Pennsylvania. HOW YOU WILL MAKE AN IMPACT - Supervise a team of claims processors, providing daily technical guidance, performance feedback, and training on WTC-specific adjudication rules. - Act as the final point of escalation for complex or high-dollar claims requiring manual review and clinical alignment with WTC-covered conditions. - Implement and monitor rigorous Quality Assurance (QA) protocols to ensure 99%+ accuracy in claim payments and adherence to HIPAA and federal regulations. - Identify bottlenecks in the claims lifecycle and collaborate with the IT and Codebook teams to automate manual processes and improve "clean claim" rates. - Generate and present weekly production metrics to leadership, tracking turn-around times (TAT), error rates, and inventory levels. - Coordinate with medical providers and federal program representatives to resolve billing disputes and clarify policy interpretations. Qualifications - Minimum of a Bachelor of Arts (BA) or Bachelor of Science (BS) degree. - 5+ years of experience in healthcare claims processing, with at least 2 years in a lead, supervisory, or senior auditing capacity. - Must have mastery of claims platforms experience (e.g., CareSuite, QNXT, Facets) and advanced Microsoft Excel skills. - Must have a comprehensive understanding of CMS-1500 and UB-04 forms, ICD-10/CPT coding, and federal reimbursement methodologies. - Must have experience managing a claims team. - Exceptional written and verbal communication skills for presenting data and managing internal and external relationships. Requirements - Prior experience supporting the World Trade Center Health Program or other federal government health contracts. - Professional certification such as CPC (Certified Professional Coder) or CHDA (Certified Health Data Analyst). - Strong analytical mindset with the ability to translate complex clinical rules into technical system requirements. Benefits - 401K with company match. - Comprehensive health and wellness packages. - Internal mobility team dedicated to helping you own your career. - Professional scientific growth opportunities, including journal subscriptions, conference attendance, and supporting publication journey. - Cutting-edge technology you can learn from. - Rest and recharge with paid vacation and holidays.

The job profile for this position is Eligibility Senior Representative, which is a Band 2 Professional Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Applicants must be located in TX, GA, PA, SC, or VA to be eligible for this role. The Senior Eligibility Representative performs specialized patient access functions requiring an advanced understanding of insurance benefits and internal processes to successfully liaise with Payers, Pharma, Physicians, and Patients. Rely on experience and knowledge of industry best practices to communicate knowledge of pending referrals that may have an adverse impact on company goals and the patient experience. Acts as a liaison between both internal and external resources to reduce client abrasion and facilitate the timely processing of referrals. This individual can proactively recognize cause and effect trends, identify and clarify patients’ needs, and work towards solutions. RESPONSIBILITIES: - Facilitate cross-functional resolution of drug coverage issues & proactively address, research & resolve issues impacting referral turn-around time. - Independently resolve basic patient claims issues using key subject matter knowledge. - Prepare and review claims to ensure accuracy to payer requirements, including but not limited to codes, dates, and authorizations. - Demonstrate technical proficiency in patient access functions. - Effectively collaborate with internal departments to resolve issues or provide any needed information, always using professional communication. - Contact benefit providers to gather policy benefits/limitations. - Coordinating and ensuring services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.). - Perform medical /pharmacy benefits verification requiring complex decision skills based on payer and process knowledge. - Provide expert assistance to internal and external clients on patient status. - Handle Escalations with an expert understanding of department policies and procedures. - Use discretion & independent judgment in handling patient or more complex client complaints, escalating as appropriate and when triaging as needed. - Complete other projects and additional duties as assigned. QUALIFICATIONS: - High school diploma or GED required, bachelor’s degree preferred. - 3+ years of relevant working experience. - 2 years of Health care experience with medical insurance knowledge and terminology and experience in patient access preferred. - Intermediate data entry skills and working knowledge of Microsoft Office, and Patient Access knowledge. - Pharmacy or healthcare industry experience is highly preferred, with prior exposure to Express Scripts (ESI) considered a strong advantage. - Experienced training and coaching less experienced staff with patience to explain details and processes repeatedly. - Excellent phone presentation and communication skills. - Demonstrated ability to handle challenging customers in a professional manner. - Ability to adapt to a dynamic work environment and make decisions with minimal supervision. - Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions. ABOUT THE DEPARTMENT Through our range of health care products and services offered, Accredo team members provide in-depth care for patients with chronic health conditions like hemophilia, oncology, rheumatoid arthritis and growth hormone deficiency. In addition to health care products, we provide comprehensive management services – including outcomes measurement, counseling, clinical care management programs, social services, and reimbursement services. By performing in these very high-touch roles, employees have a daily opportunity to make a positive impact on their patients’ lives. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.