Underpayment Analyst

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🏈 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

🟡 Mid-level

🟠 Senior

🧐 Analyst

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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

• Examine hospital claims to verify proper reimbursement • Identify discrepancies between expected and actual reimbursement amounts using company best practices, technology-enabled worklists, and internal tools • Investigate payment variances, coding errors, billing discrepancies, and incorrect payer-policy application • Contact insurance companies to obtain missing information, 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 and organizational policies • Collaborate with stakeholders to optimize reimbursement processes • Perform other duties as assigned

🎯 Requirements

• High school diploma or equivalent required • Investigative and problem-solving skills • Knowledge of healthcare billing, coding, and reimbursement methodologies • Strong analytical abilities for interpreting complex reimbursement guidelines • Ability to interpret Medicare, Medicaid, and Commercial insurance payer policies • Detail-oriented approach to applying guidelines and documenting findings for audit and compliance • Effective communication skills for collaborating 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 workspace • Secure home internet connection with download speeds above 20 Mbps and upload speeds above 10 Mbps • Workspace must accommodate workstation equipment and related materials • Must reside in the United States in an approved state listed in the posting • Employment eligibility in the United States • Successful employment-history verification and background check

🏖️ Benefits

• Comprehensive health coverage • 401(k) match • Paid training • Generous PTO • Paid holidays • 90 business days of comprehensive training beginning on the first day • Learning and development opportunities • Internal opportunities for career growth