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Underpayment Analyst

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🔥 1 minute ago

Where this job comes from

Posted on Revecore's careers page, not through a job board

First seen by Remote Rocketship 1 minute ago

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Revecore

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

• Examine hospital claims to verify accurate reimbursement for services provided • Use company best practices, technology-enabled worklists, and internal tools to identify discrepancies between expected and actual insurance reimbursements • Investigate payment variances, coding errors, billing discrepancies, and incorrect payer-policy application • Contact insurance companies to obtain missing information, explain and resolve underpayments, and arrange payment or adjustment processing on behalf of clients • Prepare and submit letters, emails, faxes, online inquiries, appeals, adjustments, reports, and payment postings • Maintain documentation of underpayment root causes, trends, outcomes, and lessons learned • Participate in discussions, meetings, and brainstorming sessions to improve processes • Uphold ethical standards and comply with healthcare reimbursement regulations, guidelines, and organizational policies • Perform other duties as assigned

🎯 Requirements

• High school diploma or equivalent required • Investigative and problem-solving skills to identify underpayments and discrepancies • Knowledge of healthcare billing, coding, and reimbursement methodologies • Strong analytical abilities to interpret complex guidelines and their implications for claims reimbursement • Ability to navigate and interpret Medicare, Medicaid, and Commercial insurance guidelines • Detail-oriented approach to applying guidelines and documenting findings for audit and compliance purposes • Effective communication skills for collaboration with internal teams, payers, and external stakeholders • Experience with healthcare billing software and databases, including EPIC, Cerner, and Meditech • Familiarity with HIPAA, CMS regulations, and state-specific healthcare reimbursement requirements • Moderate computer proficiency with MS Excel, Word, and Outlook • Technical proficiency using multiple computer screens and software applications simultaneously • Previous experience working in a remote environment • Quiet, distraction-free home work environment • Secure home internet connection with download speeds greater than 20 Mbps and upload speeds greater than 10 Mbps • Workspace accommodating workstation equipment and related materials • Must reside in the United States within one of the listed eligible states • Eligibility to work in the United States • Successful completion of a background check

🏖️ Benefits

• Comprehensive training beginning on the first day and lasting 90 business days • Remote work arrangement • Work-from-home setup

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