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From Home Remote Medical Insurance Verification Jobs in California

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From Home Remote Medical Insurance Verification information

What is the difference between From Home Remote Medical Insurance Verification vs Medical Claims Processor?

AspectFrom Home Remote Medical Insurance VerificationMedical Claims Processor
CredentialsTypically requires insurance verification certifications or knowledge of insurance policiesRequires claims processing training or certification, familiarity with billing codes
Work EnvironmentRemote, home-basedRemote or office-based, depending on employer
Industry UsageUsed in health insurance companies, healthcare providersUsed in insurance companies, healthcare billing departments
Search IntentPeople looking for remote insurance verification rolesPeople comparing claims processing jobs

While both roles operate within the healthcare insurance industry and may be remote, From Home Remote Medical Insurance Verification focuses on confirming insurance coverage details, whereas Medical Claims Processors handle the processing and adjudication of insurance claims. Understanding these differences helps job seekers find roles aligned with their skills and certifications.

What are the most commonly searched types of Remote Medical Insurance Verification jobs in California?

The most popular types of Remote Medical Insurance Verification jobs in California are:

What cities in California are hiring for From Home Remote Medical Insurance Verification jobs?

Cities in California with the most From Home Remote Medical Insurance Verification job openings:

From Home Remote Medical Insurance Verification jobs near you
Infographic showing various From Home Remote Medical Insurance Verification job openings in California as of June 2026, with employment types broken down into 70% Full Time, 23% Part Time, and 7% Contract. Highlights an 100% Remote job distribution.

Insurance Verification Manager - Expert

San Francisco, CA • Remote

Mercor
See more jobs at Mercorexternal

$105/hr

Full-time

Re-posted 27 days ago

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: Insurance Verification & Benefit Manager
Type: Contract
Compensation: $105/hour
Location: Remote

Role Responsibilities

  • Oversee insurance verification, eligibility determination, and benefits investigation workflows across commercial, Medicare, Medicaid, and managed care payers.
  • Verify patient insurance coverage using payer portals, clearinghouses, and EDI 270/271 real-time eligibility transactions.
  • Identify and resolve coordination of benefits issues, coverage gaps, and eligibility discrepancies prior to service delivery.
  • Evaluate and annotate AI-generated eligibility verification outputs for accuracy, completeness, and payer compliance.
  • Develop and document SOPs for eligibility and benefits verification workflows.
  • Monitor KPIs including verification accuracy rates, front-end denial rates related to eligibility, and turnaround times.
  • Ensure compliance with payer-specific requirements, CMS guidelines, and HIPAA regulations.
  • Identify process gaps and recommend workflow improvements to reduce eligibility-related claim denials.
  • Provide structured feedback and annotations to support AI training datasets.

Qualifications

Must-Have

  • 5+ years of experience in insurance verification, eligibility and benefits management, or front-end revenue cycle operations, with at least 2 years in a management role.
  • Expert knowledge of EDI 270/271 transactions, payer portal navigation, and real-time eligibility tools.
  • Strong familiarity with Medicare, Medicaid, and commercial payer eligibility requirements and benefit structures.
  • Proficiency with Epic, Cerner, Meditech, or equivalent EHR platforms.
  • Experience with clearinghouse platforms such as Availity, Change Healthcare, or similar.
  • Exceptional written and verbal English communication skills.
  • High attention to detail with the ability to identify subtle discrepancies in coverage data.

Preferred

  • CHAM, CHAA, or equivalent front-end revenue cycle certification.
  • Experience with automated eligibility verification tools and RPA solutions.
  • Background in denial root cause analysis related to eligibility and coverage errors.
  • Familiarity with AI tools and comfort evaluating AI-generated healthcare content.
  • Experience presenting eligibility performance data to senior leadership.

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.