Underpayment Analyst

Revecore-posted 6 days ago
Full-time • Entry Level
Remote
1,001-5,000 employees
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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.

  • 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.
  • Want to grow a career
  • Have a working knowledge of Microsoft Office (Word, Excel, Outlook)
  • Possess technical proficiency to work on multiple computer screens and software applications simultaneously
  • Can maintain strong performance in a fast-paced environment with productivity metrics
  • Have strong analytical skills, attention to detail, and problem-solving skills to identify underpayments and discrepancies
  • Have a working knowledge of healthcare billing, coding, and reimbursement methodologies
  • Can navigate and interpret various payer policies, including Medicare, Medicaid, and Commercial insurance guidelines.
  • Have experience with healthcare billing software and databases (EPIC, Cerner, Meditech)
  • Have familiarity with legal and regulatory frameworks governing healthcare reimbursement, such as HIPAA, CMS regulations, and state-specific requirements.
  • A quiet, distraction-free environment to work from in your home.
  • A secure internet connection is required.
  • Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads.
  • The workspace area accommodates all workstation equipment and related materials and provides adequate surface area to be productive.
  • We offer paid training and incentive plans
  • Our medical, dental, vision, and life insurance benefits are available from the first day of employment
  • We enjoy excellent work/life balance
  • Our Employee Resource Groups build community and foster a culture of belonging and inclusion
  • We match 401(k) contributions
  • We offer career growth opportunities
  • We celebrate 12 paid holidays and generous paid time off
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