Medical Revenue Manager

Official role description

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Charge Capture, Charge Integrity, and Revenue Integrity professionals to evaluate AI tools designed to identify revenue leakage, improve charge accuracy, and ensure coding and billing compliance. Your expertise in charge-capture workflows, CDM management, and revenue-integrity analysis will help us build AI systems that optimise revenue performance and reduce compliance risk.

Responsibilities • Oversee charge capture, charge integrity, and revenue integrity functions to ensure accurate and compliant charge submission. • Evaluate AI-generated charge review outputs, coding recommendations, and revenue integrity alerts for accuracy and compliance. • Conduct charge audits to identify missed charges, duplicate charges, and charge capture errors across clinical departments. • Manage and maintain the charge description master (CDM), ensuring accuracy of charge codes, revenue codes, and pricing. • Analyse charge patterns to identify revenue leakage opportunities and implement corrective action plans. • Collaborate with clinical, coding, and billing teams to resolve charge capture discrepancies. • Monitor KPIs including charge lag times, charge capture accuracy rates, and revenue integrity findings. • Ensure compliance with CMS billing guidelines, OIG work plan priorities, and payer-specific requirements. • Annotate AI outputs and provide structured feedback to support AI training datasets.

Requirements • 5+ years of experience in charge capture, charge integrity, revenue integrity, or healthcare compliance. • Deep knowledge of CDM management, revenue codes, charge capture workflows, and billing compliance. • Strong understanding of CMS billing guidelines, Medicare Part A/B billing rules, and OIG compliance requirements. • Proficiency with charge capture systems, EHR platforms, and revenue integrity tools. • Experience conducting charge audits and developing corrective action plans. • Exceptional written and verbal English communication skills. • High attention to detail with the ability to identify billing errors and compliance risks in AI-generated outputs.

Preferred Qualifications • CPC, CCS, CHFP, or CRCS credential. • Experience with 340B drug program charge capture and compliance. • Background in hospital, health system, or physician group revenue integrity operations. • Familiarity with AI tools and comfort evaluating AI-generated charge and billing content. • Experience with revenue integrity software platforms and analytics tools.

Why Join? • Contribute to the development of frontier AI systems in healthcare. • Collaborate with a world-class AI research organisation. • Gain exposure to cutting-edge AI workflows in healthcare revenue integrity. • Opportunity to work on high-impact projects shaping the future of healthcare AI.