Denials Recovery Analyst

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🔥 0 minutes ago

🏈 Alabama, Connecticut, +26 more states – Remote

🏈 Alabama – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🌾 Nebraska – Remote 🗻 New Hampshire – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

🚫👨‍🎓 No degree required

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Revecore

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Revecore is a healthcare revenue recovery company that combines proprietary AI, claims intelligence, workflow automation, and clinical, legal, and reimbursement expertise to identify and recover missed revenue for hospitals and health systems. Their ReClaim™ platform and network intelligence use machine-learning models and payor rule engines trained on hundreds of millions of claims to automate decisioning, prioritize recoveries, manage complex claims (VA, auto accidents, workers' compensation, Medicaid), denials management, underpayment recovery, and accounts receivable acceleration. Revecore operates HIPAA-compliant, SOC 2-certified infrastructure and serves over 1,300 hospitals, emphasizing outcomes like increased reimbursement, faster reimbursement, and high denial overturn rates.

📋 Description

• Research commercial and governmental payor policies, clinical abstracts and studies, and related documentation to evaluate and appeal denied claims • Examine claims and calculate reimbursement using contract terms, reports, and supporting documentation • Review insurance contracts and payment methodologies • Contact insurance companies to obtain missing information, resolve denials, and arrange payment or adjustment processing • Follow up on claims according to company and departmental policies • Document information in Revecore and client systems • Prepare and submit letters, emails, online inquiries, appeals, adjustments, reports, and payment postings • Maintain contact with payors, clients, managers, and Revecore personnel regarding claim status • Communicate with client contacts about billing, posting, contracts, and related issues • Promote positive public relations and maintain a professional approach with payors • Build relationships with clients, payors, and Revecore personnel • Support and direct claims to Revecore departments and client onsite analysts • Attend client, department, and company meetings • Comply with federal and state laws, company policies, and procedures

🎯 Requirements

• Minimum 2 years of insurance billing, denial management and/or utilization review experience • Experience reviewing and analyzing hospital claims • Knowledge of CPT, ICD-9, ICD-10, HCPC, and DRG healthcare codes, with ability to apply them operationally • High school diploma or equivalent • Working knowledge of Microsoft Office Suite, including Word and Excel • Moderate computer proficiency • Ability to calculate rates using addition, subtraction, multiplication, and division • Ability to read and interpret contracts, claims, instructions, policies, procedures, and diagrams in English • Ability to write routine correspondence in English • Ability to define problems, collect data, establish facts, and draw valid conclusions • Strong customer service orientation • Excellent interpersonal and communication skills • Commitment to company values • Quiet, distraction-free home work environment • Reliable hard-wired private internet connection; cellular data or hotspot is not permitted • Home internet speeds greater than 20 Mbps download and 10 Mbps upload • Workspace sufficient for workstation equipment and productive work • Must reside in the United States in an approved state listed in the posting • Employment eligibility in the United States, employment-history verification, and successful background check

🏖️ Benefits

• Comprehensive health coverage • 401(k) match • Paid training • Generous PTO • Paid holidays • Learning, development, and internal opportunities • Remote work from home