Underpayment Analyst at Revecore

, , United States -

Full Time

Start Date

Immediate

Expiry Date

17 Apr, 26

Salary

0.0

Posted On

17 Jan, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Analytical Skills, Attention to Detail, Problem-Solving Skills, Healthcare Billing, Coding, Reimbursement Methodologies, Payer Policies, Microsoft Office, Healthcare Billing Software, Databases, HIPAA, CMS Regulations, State-Specific Requirements

Industry

Hospitals and Health Care

Description

Our Company Start your next chapter at Revecore! For over 25 years, we’ve been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We’re powered by people, driven by technology, and dedicated to our clients and employees. As part of our team, you’ll be rewarded with: * Competitive compensation with eligibility for a quarterly bonus * Comprehensive medical, dental, vision, and life insurance benefits from day 1 * 12 paid holidays and flexible paid time off * 401(k) with company match * Employee Resource Groups that build community * Career growth opportunities * An excellent work/life balance Location: Remote-US Start your next chapter at Revecore! For over 25 years, Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We're powered by people, driven by technology, and dedicated to our clients and employees. If you're looking for a collaborative and diverse culture with a great work/life balance, look no further. As an Underpayment Analyst at Revecore, you hold a pivotal position in ensuring hospitals receive accurate compensation for the services they provide. Your role involves examining hospital claims to verify proper reimbursement and work with stakeholders to resolve issues and optimize reimbursement processes while adhering to regulatory guidelines and organizational policies. Training: Our comprehensive training begins on your first day and lasts 90 business days. It is led by instructors and incorporates interactive discussions and hands-on activities to accommodate diverse learning preferences. Responsibilities: * Utilize company best practices along with technology enabled worklist and other internal tools to identify discrepancies between expected reimbursement and actual reimbursement amounts from insurance carriers * Investigate reasons for discrepancies, such as payment variances, coding errors, billing discrepancies, or incorrect application of payer policies * Contact insurance companies to obtain missing information, explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client * Prepare and submit correspondence such as letters, emails, faxes, online inquiries, appeals, adjustments, reports and payment posting * Maintain thorough documentation, including root cause of underpayment issues, trends, outcomes, and lessons learned to support ongoing improvement efforts and knowledge sharing within the organization * Actively participate in discussions, meetings, and brainstorming sessions where team members contribute insights and suggestions for improving processes * Demonstrate a commitment to upholding ethical standards and compliance with relevant regulations and guidelines in all reimbursement optimization activities Do you possess: * A desire to grow your career * A working knowledge of Microsoft Office (Word, Excel, Outlook) * Technical proficiency to work on multiple computer screens and software applications simultaneously * Momentum for strong performance in a fast-paced environment with productivity metrics * Strong analytical skills, attention to detail, and problem-solving skills to identify underpayments and discrepancies * A working knowledge of healthcare billing, coding, and reimbursement methodologies * The ability to navigate and interpret various payer policies, including Medicare, Medicaid, and Commercial insurance guidelines * Experience with healthcare billing software and databases (EPIC, Cerner, Meditech) * A familiarity with legal and regulatory frameworks governing healthcare reimbursement, such as HIPAA, CMS regulations, and state-specific requirements If so, we want to hear from you! How we'll set you up for success: * Extensive multi-week training with ongoing support from teammates following training * Access to a robust knowledgebase for continued reference in your role * Visibility to your individual performance metrics enables you to set goals * Computers and necessary work equipment are provided  * Involved management who leans in to support your productivity metrics Work at Home Requirements:  * A quiet, distraction-free environment to work from in your home.   * A secure home internet connection with speeds >20 Mbps for downloads and >10 Mbps for uploads is required. * The workspace area accommodates all workstation equipment and related materials and provides adequate surface area to be productive.   Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check. Revecore is an affirmative action-equal opportunity employer that does not discriminate based on race, color, religion, sex or gender, gender identity or expression, sexual orientation, national origin, age, disability status, veteran status, genetic information, or any other legally protected status. We believe that a diverse workforce fosters innovation and creativity, enriches our culture, and enables us to better serve the needs of our clients and communities. We welcome and encourage individuals of all backgrounds, perspectives, and abilities to apply. Must reside in the United States within one of the states listed below: Alabama, Arkansas, Connecticut, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia and Wisconsin #LI-DNI

Responsibilities

As an Underpayment Analyst, you will examine hospital claims to verify proper reimbursement and work with stakeholders to resolve issues. Your role also involves maintaining thorough documentation and participating in discussions to improve processes.