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Healthcare / Healthcare

Revecore Hiring for Medicare Claims Analyst at Remote Full Time

Full Job Description

Revecore is an innovative, technology-driven company that is committed to helping our clients, our employees, our company, and our communities thrive. An award-winning services firm, partnering with hospitals and health systems, providing the momentum they need to maintain a strong revenue cycle amid today’s evolving healthcare environment.
With a 20+ year history, Revecore is the leading provider of revenue integrity and complex claims solutions for hospitals.
We offer a dynamic and flexible work environment, full of opportunity for motivated, hands-on team players. We strive each day to solve complex business problems and find new ways to enhance the efficiency, effectiveness, and quality of our services. If those attributes resonate with you, regardless of where you are located—we want you on our team!
Location: Remote
The Role:
Join our innovative team as a Medicare Claims Analyst. Primarily Responsible for thorough review of managed care contracts and comparison of such contracts against Medicare claims to identify underpayments for the assigned client. Apply now and become an integral part of our mission to deliver efficient, accurate, and compassionate healthcare payment solutions!
As a Medicare Claims Analyst, you will:
  • Build strong, lasting relationships with clients, payors and Revecore personnel
  • Review insurance contracts to gain thorough understanding of payment methodologies
  • Examine Medicare Advantage claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various s and supporting documentation
  • 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, s and payment posting
  • Maintain regular contact with necessary parties regarding claims status including payors, clients, managers and other Revecore personnel
  • Support and direct claims to all Revecore departments and client onsite analysts
  • Attend client, department and company meetings
  • Comply with federal and state laws, company and department policies and procedures
You will be successful if you have:
  • Accounts receivable collections experience from payors (no self-pay)
  • Ability to effectively identify and communicate payor trends
  • Organization and documentation skills to ensure timely follow-up and accurate record keeping
  • Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division
  • Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form
  • Ability to present written routine correspondence (in English)
  • Ability to present ideas on complex, detailed issues with ease
  • Ability to define problems, collect data, establish facts and draw valid conclusions
  • Strong customer service orientation
  • Excellent interpersonal and communication skills
  • Commitment to our company values
Education and Experience Requirements
  • Minimum 2 years of experience working in an operational setting, preferably managed care or hospital patient accounts
  • High School diploma or equivalent
  • Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook
  • Experience working with ICD-9, CPT-4 and/or HCPCS coding systems
  • Knowledge of insurance submittal procedures and medial forms (including UB04 and CMS1500)
  • Experience performing account resolution with third party payors
  • Experience working with Medicare pricing software
Why Join Revecore?
  • Fully remote work.
  • Medical, dental, vision, and life insurance benefits are available from the first day of employment.
  • 401(k) with employer match after 90 days.
  • Generous PTO plan
  • 12 paid holidays
  • All computer and necessary hardware are provided to you.
About Revecore
As a multi-year award winning services team, we partner with hospitals and health systems to become a trusted advisor and extension of their billing office.
Our Revenue Integrity division, based out of Crescent Springs, KY and Cincinnati, OH, specializes in identifying, recovering, and preventing underpayments and denials from commercial and government payers. Our data-driven solutions are fueled by The Bridge, our proprietary technology that delivers actionable intelligence and our people allow us to leverage that technology to strengthen a hospital’s internal systems and prevent future losses.
Our Complex Claims division, based out of Franklin, TN, delivers reimbursement solutions that identify and recover overlooked revenue for hospitals and health systems nationwide. AcciClaim, our innovative technology platform seamlessly resolves accident-related medical claims, securing accurate reimbursement while eliminating the administrative pain of billing for Motor Vehicle and Workers’ Compensation accidents and Veterans Affairs Claims.
Revecore is committed to creating a diverse and inclusive work environment where all employees feel valued, respected, and supported. Our company is an equal opportunity employer that does not discriminate on the basis of 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 value diversity and inclusion and believe that everyone should be treated with respect and dignity. We encourage all qualified individuals to apply for our open positions and welcome candidates from all backgrounds to join our team.
This opportunity is remote and open to candidates in Alabama, Arkansas, Arizona, Connecticut, Delaware, Florida, Georgia, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Maryland, Michigan, Minnesota, Missouri, Mississippi, Montana, North Carolina, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Wisconsin, and West Virginia.

Job Overview

  • ID: 366765
  • Date Posted:
  • Location:
  • Job Title: Revecore Hiring for Medicare Claims Analyst at Remote