Job Opportunities API

At Revecore, our work helps hospitals recover the revenue they've earned so they can continue serving patients and communities. Trusted by more than 1,300 hospitals across 48 states, we combine specialized expertise with proprietary technology to solve problems others can't. Just as importantly, we've built a workplace where people support one another, embrace innovation, and are trusted to do their best work. Work that matters. People who care. Empowered to deliver results. Why Work Here Work That Matters - Help hospitals and communities by solving problems that make a real difference. People Who Care - Work alongside teammates who support each other and our clients. Room to Grow - Grow your career through learning, development, and internal opportunities. Empowered to Deliver - Take ownership, use innovative technology, and do your best work. Benefits That Support You - Comprehensive health coverage, 401(k) match, paid training, generous PTO, paid holidays, and more. Denial Recovery Analyst Primarily responsible for thorough review of managed care contracts and comparison of such contracts against healthcare 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! Responsibilities - Research commercial and governmental payor policies, clinical abstracts and studies, and other documentation related to claims payment to evaluate and appeal denied claims - Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation - Review insurance contracts to gain thorough understanding of payment methodologies - Contact insurance companies to obtain missing information, explain and resolve denials and arrange for payment or adjustment processing on behalf of client - Follow up on claims in a timely fashion as outlined in Revecore and/or departmental policies and procedures - Document information within appropriate Revecore and client systems - Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting - Maintain regular contact with necessary parties regarding claims status including payors, clients, managers, and other Revecore personnel - Communicate with client contact concerning all issues related to billing, posting, contracts and all other client related issues, both in an informal manner through daily contact and formal manner through scheduled meetings - Promotes positive public relations for Revecore, including maintaining a professional attitude and approach with all payors - Build strong, lasting relationships with clients, payors and 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 policies and procedures You will be successful if you have - Working knowledge of Microsoft Office suite (Word, Excel) - Moderate computer proficiency - 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 write routine correspondence (in English) - Ability to define problems, collect data, establish facts and draw valid conclusions - Strong customer service orientation - Excellent interpersonal and communication skills - Commitment to company values Qualifications - Minimum 2 years of insurance billing, denial management and/or utilization review experience: - Experience reviewing and analyzing hospital claims - Knowledge of healthcare codes including CPT, ICD-9, ICD-10, HCPC, DRG, and ability to correct