Revecore
Revecore
1 001 – 5 000 Darbuotojai
B2BSaaSSveikatos priežiūra
„Revecore“ yra sveikatos priežiūros pajamų susigrąžinimo įmonė, padedanti ligoninėms ir sveikatos priežiūros sistemoms rasti bei susigrąžinti kompensacijas, kurios kitu atveju galėtų likti negautos. Jos „ReClaim™“ platforma sujungia nuosavą dirbtinį intelektą, žalų analizę, darbo eigos automatizavimą ir draudikų taisyklių variklius su klinikine, teisine ir kompensacijų srities patirtimi. Platforma padeda susigrąžinti sudėtingas kompensacijas, įskaitant su veteranais, eismo įvykiais, darbuotojų kompensacijomis ir „Medicaid“ susijusias išmokas, taip pat valdyti atmestas paraiškas, susigrąžinti nepakankamai išmokėtas sumas ir paspartinti gautinų sumų surinkimą. HIPAA reikalavimus atitinkanti ir SOC 2 sertifikuota „Revecore“ infrastruktūra naudoja mašininio mokymosi modelius, išmokytus naudojant šimtus milijonų paraiškų, o įmonė aptarnauja daugiau nei 1 300 ligoninių. Jos komandą sudaro sveikatos priežiūros technologijų, pajamų ciklo operacijų, klinikinių paslaugų, teisės ir kompensacijų sričių specialistai.

Remote Variance Underpayment Analyst at Revecore

Revecore is seeking a remote Variance Underpayment Analyst to help hospitals recover revenue. The role reviews claims discrepancies, investigates reimbursement issues, and works with insurance carriers to resolve underpayments.

Aprašymas

  • Review hospital claims to confirm accurate reimbursement
  • Compare expected and actual insurance-carrier payments using established practices, technology-enabled worklists, and internal tools
  • Investigate payment variances, coding mistakes, billing discrepancies, and incorrect application of payer policies
  • Work with insurance companies to gather missing information, explain and resolve underpayments, and coordinate payment or adjustment processing for clients
  • Prepare and submit correspondence, online inquiries, appeals, adjustments, reports, and payment postings
  • Document underpayment root causes, trends, outcomes, and lessons learned
  • Contribute to discussions, meetings, and brainstorming aimed at improving processes
  • Follow ethical standards, applicable regulations, and organizational policies
  • Complete other assigned duties

Reikalavimai

  • High school diploma or equivalent
  • Investigative and problem-solving ability to identify underpayments and discrepancies
  • Working knowledge of healthcare billing, coding, and reimbursement methods
  • Strong analytical skills for interpreting complex guidelines and applying them to claim reimbursement
  • Ability to navigate and interpret Medicare, Medicaid, and commercial insurance guidelines
  • High attention to detail when applying guidelines and maintaining documentation
  • Clear communication skills for working with internal teams, payers, and external stakeholders
  • Experience using healthcare billing software and databases such as EPIC, Cerner, and Meditech
  • Familiarity with HIPAA, CMS regulations, and state-specific healthcare reimbursement requirements
  • Moderate proficiency with Microsoft Excel, Word, and Outlook
  • Ability to work across multiple monitors and software applications simultaneously
  • Prior experience working remotely
  • Quiet, distraction-free home workspace
  • Secure home internet with download speeds above 20 Mbps and upload speeds above 10 Mbps
  • Workspace suitable for company equipment and related materials
  • Residence in the United States within an eligible listed state
  • Authorization to work in the United States
  • Successful background check

Privalumai

  • Comprehensive 90-business-day training starting on the first day
  • Remote work arrangement
  • Work-from-home setup
  • Equal employment opportunity workplace

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