Denials Recovery Analyst

Ready to make a difference for hospitals while working from home? 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.Revecore Perks:We offer paid training and incentive plansOur medical, dental, vision, and life insurance benefits are available from the first day of employmentWe enjoy excellent work/life balanceOur Employee Resource Groups build community and foster a culture of belonging and inclusionWe match 401(k) contributionsWe offer career growth opportunitiesWe celebrate 12 paid holidays and generous paid time off Location: Remote -- USAThe Role: Denial Recovery AnalystPrimarily 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!As a Denial Recovery Analyst, you will:Research commercial and governmental payor policies, clinical abstracts and studies, and other documentation related to claims payment to evaluate and appeal denied claimsExamine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentationReview insurance contracts to gain thorough understanding of payment methodologiesContact insurance company to obtain missing information, explain and resolve denials and arrange for payment or adjustment processing on behalf of clientFollow up on claims in a timely fashion as outlined in Revecore and/or departmental policies and proceduresDocument information in appropriate Revecore and client systemsPrepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment postingMaintain regular contact with necessary parties regarding claims status including payors, clients, managers, and other Revecore personnelCommunicate 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 meetingsPromotes positive public relations for Revecore, including maintaining a professional attitude and approach with all payorsBuild strong, lasting relationships with clients, payors and Revecore personnelSupport and direct claims to all Revecore departments and client onsite analystsAttend client, department and company meetingsComply with federal and state laws, company policies and proceduresAll other duties as assignedYou will be successful if you have:Working knowledge of Microsoft Office suite (Word, Excel)Moderate computer proficiencyMathematical skills: ability to calculate rates using addition, subtraction, multiplication and divisionAbility to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram formAbility to write routine correspondence (in English)Ability to define problems, collect data, establish facts and draw valid conclusionsStrong customer service orientationExcellent interpersonal and communication skillsCommitment to company valuesEducation and Experience Requirements:Minimum 2 years of insurance billing, denial management and/or utilization review experience:Experience reviewing and analyzing hospital claimsKnowledge of healthcare codes including CPT, ICD-9, ICD-10, HCPC, DRG, and ability to correctly use and apply codes in operational settingHigh school diploma or equivalentWork at Home Requirements:A quiet, distraction-free environment to work from in your home.A reliable hard-wired private internet connection that is not supplied via cellular data or hotspot is required.Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads.The workspace area accommodates all workstation equipment, related materials, and provides adequate surface area to be productive.Revecore 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 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, Iowa, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Michigan, Minnesota, Missouri, Mississippi, North Carolina, Nebraska, New Hampshire, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota (CST Time Zone), Tennessee, Texas (CST Time Zone), Vermont, Virginia, Wisconsin, and West Virginia.Originally posted on Himalayas

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