Medical Billing Manager for AI Evaluation

Lead and improve end-to-end medical billing and claims operations while evaluating and providing expert feedback on AI-generated billing outputs. This role combines hands-on revenue cycle leadership with detailed review of claims, payer rules, and EDI transactions to help increase first-pass claim acceptance and overall billing accuracy for a leading AI research organization.

• Oversee complete medical billing and claims submission processes for professional fee and/or facility billing environments.
• Review and evaluate AI-produced billing line items, claim edits, and coding validations for accuracy and payer compliance.
• Manage claims submission workflows, including electronic claim creation, clearinghouse edits, and payer-specific requirements.
• Track and analyze clean claim rates, rejection rates, and first-pass acceptance rates, and design strategies to improve those metrics.
• Coordinate with coding, clinical documentation improvement, and collections teams to resolve billing edits and claim denials.
• Ensure adherence to CMS billing guidelines, HIPAA 837 transaction standards, and payer-specific billing rules.
• Supervise billing staff, monitor workload distribution, productivity, and quality performance measures.
• Create and maintain billing standard operating procedures and payer-specific reference guides.
• Annotate AI outputs and deliver structured, actionable feedback to support AI training datasets and model improvement.

• Minimum 5 years of experience in medical billing and claims management, including at least 2 years in a management or supervisory role.
• Deep familiarity with professional fee billing (CMS-1500, 837P) and/or facility billing (UB-04, 837I) requirements.
• Expert understanding of HIPAA 837 transaction standards, clearinghouse operations, and payer-specific billing rules.
• Solid knowledge of Medicare, Medicaid, and commercial payer billing policies.
• Proficiency with billing and RCM platforms, examples include Epic, Athenahealth, AdvancedMD, or similar systems, and experience with clearinghouse tools.
• Exceptional written and verbal English communication skills.
• Strong attention to detail, with the ability to detect billing errors and compliance issues in AI-generated outputs.

• Certifications such as CPC, CCS, CHFP, or CRCR.
• Experience with automated billing platforms and revenue cycle management technology implementations.
• Background in multi-specialty physician group, hospital, or health system billing operations.
• Familiarity with AI tools and experience evaluating AI-generated billing content.
• Experience interpreting payer contracts and managing billing compliance programs.

• Location: Remote.
• Employment type: Hourly.
• This role requires active participation in billing operations and evaluation activities as described in the responsibilities.

• Hourly rate: $80.00 per hour.

• No specific work-authorization or visa sponsorship details were provided in the source listing; applicants should ensure they are authorized to work remotely for the hiring organization.

• Contribute domain expertise to the development of advanced AI systems in healthcare.
• Work with a leading AI research organization on projects that shape the future of medical billing and revenue cycle performance.
• Gain exposure to cutting-edge AI workflows applied to billing, claims automation, and revenue cycle optimization.