? Hiring: Payer Policy Specialist – Healthcare AI Evaluation Project

We are looking for an experienced Payer Policy Specialist to support a short-term Healthcare AI Evaluation Project .

? Role: Payer Policy Specialist

? Experience: 3+ years

? Work Mode: Remote

? Key Responsibilities

- Review and evaluate healthcare payer policies, coverage criteria, and medical guidelines .
- Analyze payer policies to determine coverage, eligibility, and medical necessity requirements .
- Validate policy information against relevant source documents and guidelines.
- Identify discrepancies, gaps, or inconsistencies in policy interpretation.
- Review and assess clinical and administrative criteria used in payer decision-making.
- Provide accurate documentation and feedback to support the evaluation process.

? Requirements
- 3+ years of experience in payer policy, health insurance, utilization management, medical review, or a related healthcare field.




- Strong understanding of health insurance policies, coverage criteria, and medical necessity guidelines .
- Experience reviewing and interpreting payer policies and clinical documentation.
- Solid analytical and research skills with excellent attention to detail.
- Ability to work with structured documentation and evaluate information against defined criteria.
- Experience with healthcare QA, medical policy review, or healthcare AI evaluation will be an advantage.

? Interested? Please share your updated resume via LinkedIn message , along with a brief summary of your relevant payer policy/healthcare experience .

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📌 Payer policy specialist (India)
🏢 MyRemoteTeam
📍 India