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Role Description
We are seeking a Contractor with experience in healthcare, insurance verification, and specialty pharmacy operations to support an AI lab in building advanced automation tools for payer communication. This role focuses on creating high-quality benefits investigation call scripts used to guide phone interactions with insurance payers.
- 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 that ensure accurate and auditable responses.
- Incorporate payer-specific nuances, such as medical vs. pharmacy benefits, prior authorization rules, step therapy, 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.
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 that guide others to extract complete payer information.
- Excellent written communication and documentation skills with strong attention to detail.
- Prior experience conducting payer calls or working in benefits verification is a plus.
Company Description
This position is a contract-based opportunity through Mercor, hiring on behalf of a leading AI lab developing tools for healthcare process automation. You will collaborate with teams that combine pharmacy operations expertise and AI-driven workflow optimization.
- Commitment: ~20-30 hours/week
- Type: Contractor (Independent)
- Location: Remote
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