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Revecore este o companie de recuperare a veniturilor din domeniul asistenței medicale, care ajută spitalele și sistemele de sănătate să identifice și să încaseze rambursări care altfel ar putea fi omise. Platforma ReClaim™ combină inteligența artificială proprietară, informațiile despre cereri, automatizarea fluxurilor de lucru și motoare de reguli pentru plătitori cu expertiză clinică, juridică și în domeniul rambursărilor. Platforma sprijină recuperarea cererilor complexe, inclusiv cereri VA, rezultate în urma accidentelor auto, cereri de despăgubire pentru accidente de muncă și cereri Medicaid, precum și gestionarea refuzurilor, recuperarea plăților insuficiente și accelerarea creanțelor. Infrastructura Revecore, conformă cu HIPAA și certificată SOC 2, utilizează modele de învățare automată antrenate pe sute de milioane de cereri, iar compania deservește peste 1.300 de spitale. Echipa sa reunește expertiză în tehnologia medicală, operațiuni ale ciclului veniturilor, servicii clinice, domeniul juridic și rambursări.
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.
Statele Unite ale Americii
Alabama
Connecticut
Florida
Iowa
Kansas
Kentucky
Louisiana
Maine
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Nebraska
New Hampshire
Carolina de Nord
Ohio
Oklahoma
Pennsylvania
Rhode Island
Carolina de Sud
Dakota de Sud
Tennessee
Texas
Vermont
Virginia
Virginia de Vest
WisconsinRemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăAnalistDescriere
- 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
Cerințe
- 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
Beneficii
- 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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