Insurance Verification AI Evaluation Specialist

About OpenTrain AI

OpenTrain AI is the centralized platform where people build careers in AI training and data labeling. We help freelancers find projects, consolidate proof of work, and grow a lasting portfolio that demonstrates real experience in shaping AI systems.

OpenTrain AI is the hiring and contracting organization for this role. We connect skilled contributors with high-impact evaluation work that directly improves model behavior and downstream automation in industry workflows.

About AI training and why this work matters

AI training (data labeling and human feedback) is the human side of building intelligent systems. Contributors curate, evaluate, and correct AI outputs so models learn to make accurate, reliable decisions.

This role places you at the intersection of healthcare operations and AI: your expertise will help the model make correct eligibility determinations and reduce real-world revenue-cycle errors that lead to claim denials.

• Work is 100% remote and often flexible—ideal for experienced professionals seeking part-time contractor work.
• Your feedback will be used for evaluation ratings and RLHF-style training to improve model accuracy on insurance verification tasks.

The role

As an Insurance Verification AI Evaluation Specialist you will review AI-generated eligibility and coverage outputs, verify coverage through payer portals and clearinghouses, and confirm real-time EDI 270/271 transactions. You will produce structured feedback and ratings that improve AI behavior in front-end revenue-cycle automation.

OpenTrain AI expects subject-matter expertise in payer rules and verification workflows; this is an expert-level contractor role focused on accuracy, compliance, and measurable reductions in eligibility-related denials.

• Role type: Contractor, Part-time (default 20 hrs/week).
• Location: Remote — United States only.
• Labeling work: Evaluation rating and RLHF-style feedback on text outputs and eligibility determinations.

What you'll do day-to-day

You will evaluate AI outputs for accuracy, completeness, and payer compliance; verify coverage using payer portals, clearinghouses, and EDI 270/271 transactions; and document findings and process improvements.

You will also monitor verification accuracy metrics, identify coordination-of-benefits and coverage gaps before service delivery, and recommend SOP changes that reduce eligibility-related denials.

• Review AI-generated eligibility verifications and assign evaluation ratings.
• Perform live verification via payer portals, clearinghouses, and real-time EDI 270/271 transactions.
• Identify coordination of benefits issues and eligibility discrepancies prior to service.
• Document SOPs and suggest workflow changes to reduce denials and improve turnaround times.
• Track verification accuracy, denial rates, and turnaround metrics to inform model training.

Qualifications and required experience

The role requires deep revenue-cycle experience and payer-eligibility expertise. Every requirement below is essential unless noted as preferred.

• 5+ years in insurance verification, eligibility and benefits management, or front-end revenue cycle operations.
• 2+ years in a management role overseeing verification or front-end revenue-cycle teams.
• Expert knowledge of EDI 270/271 transactions and real-time eligibility tools.
• Hands-on experience with Medicare, Medicaid, and commercial payer eligibility requirements.
• Proficiency with Epic, Cerner, Meditech, or similar EHR platforms.
• Experience with Availity, Change Healthcare, or comparable clearinghouse tools.
• Exceptional written and verbal English communication skills.
• CHAM, CHAA, or equivalent front-end revenue-cycle certification is preferred (not required).

Who should apply

Apply if you are an experienced revenue-cycle professional who wants to use your payer-eligibility expertise to improve AI systems and downstream automation. This role suits managers and senior individual contributors who enjoy process improvement and structured evaluation work.

This is a contractor position for US-based contributors only; fluency in English and demonstrated payer-eligibility experience are required.

• Ideal for managers or senior analysts with a strong track record in front-end revenue cycle and verification.
• Good fit for professionals who want part-time, high-pay, skills-based remote work while contributing to AI training.

Compensation, schedule, and how to apply

Compensation is $105 per hour for contractor work with a default commitment of 20 hours per week. OpenTrain AI handles contracting for this position.

To apply, create or update your OpenTrain profile with your payer-eligibility experience, certifications (CHAM/CHAA if held), and examples of work managing verification or clearinghouse workflows. OpenTrain will use that profile to match you to this role and forward evaluation tasks.

• Hourly rate: $105/hour (PAY_PER_HOUR, USD).
• Time requirement: Default 20+ hours/week (part-time contractor).
• Location: Remote — United States only.
• Work labels: Evaluation ratings and RLHF-style feedback on text outputs.
• Languages: English required.