Revecore

Role Description As an Auto Claims Specialist at Revecore, you will make high-volume, outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies, on behalf of our clients (hospitals and medical providers). - Investigate and research details of an auto accident to determine the payer. - Make high volume of outbound calls to patients, insurance company representatives, and attorneys. - Submit bills and proper documentation to the insurance company, ensuring maximized payments to our clients (medical providers). - Determine follow-up steps and resubmit bills for additional payment if bills aren't paid correctly. - Contribute to your team with various denial reports, audits, and overall support. Qualifications - 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, high outbound call center environment with productivity metrics. - Remain organized while multi-tasking. - Use critical thinking and problem-solving skills to find effective and efficient solutions. - Communicate clearly, both verbally and in writing. - Experience with Coordination of Benefits and a general understanding of insurance billing (a plus, but not required). Requirements - A private, distraction-free environment to work from in your home. - On-Camera Presence: Being on camera is an essential part of our culture. - A secure internet connection. - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads. - Workspace area must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset). - Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check. - Must reside in the United States within one of the specified states. Benefits - Paid training and incentive plans. - Medical, dental, vision, and life insurance benefits available on day 1. - Excellent work/life balance. - Employee Resource Groups build community and foster a culture of belonging and inclusion. - 401(k) contributions matched. - Career growth opportunities. - 12 paid holidays and generous paid time off.

Role Description As a Senior Machine Learning Engineer (individual contributor) at Revecore, you will: - Use your expertise in machine learning, exploratory data analysis, and software engineering to enhance the productivity and efficiency of our underpayment business. - Work on projects with purpose, such as prioritizing claims based on expected recovery dollars and improving our claim-remit matching process. - Own end-to-end development, training, deployment, evaluation, and improvement of machine learning systems to rank claim opportunities. - Analyze and explore data to identify actionable opportunities from internal and 3rd party data. - Research, implement, and launch new model architectures that drive business impact. - Partner and collaborate with cross-functional teams of software engineers, data engineers, subject matter experts, product managers, and analysts to design and build practical solutions. - Implement cloud MLOps and AIOps best practices to streamline the development, deployment, and maintenance of machine learning models. - Continuously measure the impact of the AI-enabled workflows on key business metrics and use these measurements to improve the machine learning models and workflows. - Learn from and teach your teammates, being the team’s expert in your specialization. - Own a workstream, being the technical lead for the workstream while partnering with others to deliver. Qualifications - A bachelor's degree in any data-centric field; scientific thinking is a must. - Experience working in a similar role, with a focus on machine learning or data science. - Experience developing and deploying machine learning models in a production environment. - Strong experience with Python, including scikit-learn; TensorFlow or PyTorch is a plus. - Ability to wrangle data, perform exploratory data analysis, and draw insights from visualizations. Requirements - An urge to question assumptions and to get it right (or at least good enough) even if your first idea is wrong. - A commitment to collaborate, rather than go off in a corner only to appear when you need to submit a pull request. Benefits - Comprehensive medical, dental, vision, and life insurance benefits from the start of your employment. - 12 paid holidays and flexible paid time off. - 401(k) contributions. - Employee Resource Groups that build community. - Career growth opportunities. - An excellent work/life balance. 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.

Role Description As an Auto Claims billing specialist at Revecore, you will make high-volume, outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies, on behalf of our clients (hospitals and medical providers). Your Day: - Investigate and research details of an auto accident to determine the payer. - Make a high volume of outbound calls to patients, insurance company representatives, and attorneys. - Submit bills and proper documentation to the insurance company, ensuring maximized payments to our clients (medical providers). - Determine follow-up steps and resubmit bills for additional payment if bills aren't paid correctly. - Contribute to your team with various denial reports, audits, and overall support. Qualifications - Driven and highly motivated to be successful. - Working knowledge of Microsoft Office (Word, Excel, Outlook). - Technical proficiency to work on multiple computer screens and software applications simultaneously. - Ability to maintain strong performance in a fast-paced environment with productivity metrics. - Organized while multi-tasking. - Strong critical thinking and problem-solving skills. - Clear communication skills, both verbally and in writing. - Experience with Coordination of Benefits and a general understanding of insurance billing (a plus, but not required). Requirements - A private, distraction-free environment to work from in your home. - On-Camera Presence: Being on camera is essential for building trust, supporting collaboration, and strengthening team connections. - A secure internet connection. - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads. - Workspace area accommodates all workstation equipment and provides adequate surface area to be productive. - Must reside in the United States within specified states. Benefits - Paid training and incentive plans. - Medical, dental, vision, and life insurance benefits available from the first day of employment. - Excellent work/life balance. - Employee Resource Groups build community and foster a culture of belonging and inclusion. - 401(k) contributions matched. - Career growth opportunities. - 12 paid holidays and generous paid time off.

Role Description The VA Claims Specialist will investigate health insurance claims and bills to ensure claims resolution. Responsibilities include: - Following up on unresolved claims - Facilitating payment of claims for Veterans' Affairs and its affiliates Training: - Comprehensive training begins on your first day and lasts 8-10 business days - Led by instructors with interactive discussions and hands-on activities - Participation is essential for success Qualifications - Working knowledge of Microsoft Office (Word, Excel, Outlook) - Technical proficiency to work on multiple computer screens and software applications simultaneously - Ability to maintain strong performance in a fast-paced environment with productivity metrics - Organizational skills while multi-tasking - Critical thinking and problem-solving skills - Clear communication skills, both verbally and in writing - Investigative mindset - Experience in a professional office environment - General understanding of insurance billing (a plus, but not required) - Experience with billing and appealing denied health claims (a plus, but not required) Requirements - A private, distraction-free environment to work within your home - On-Camera Presence: Being on camera is essential for building trust and collaboration - A secure internet connection - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads - Workspace must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset) - Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check Benefits - Paid training and incentive plans - Medical, dental, vision, and life insurance benefits available on day 1 - Excellent work/life balance - Employee Resource Groups build community and foster a culture of belonging and inclusion - 401(k) contributions matched - Career growth opportunities - 12 paid holidays and generous paid time off

Role Description As an Operations Specialist at Revecore, you hold a pivotal position in ensuring hospitals receive accurate compensation for the services they provide. In this role you will leverage subject matter expertise to improve the accuracy, quality and prioritization of claims delivered to our analyst worklists. Each day may look a little different as you balance the various responsibilities of supporting your team; however, a portion of your time will be reserved to test and provide insights on new AI models that will improve results for your team, for Revecore and our Clients. Responsibilities - Provide training and onboarding support to new analysts as outlined in the Training and Development Onboarding programs. - Provide assistance to address analysts' technical questions and needs on claims handling. - Participate in the quality assurance process for the department, ensuring all applicable guidelines/deadlines are successfully achieved. - May review and approve adjustments on claims, up to a predetermined amount. - Review claims associated with new AI models that will drive improvements in the assignment and prioritization of claims in the future. - Utilize subject matter expertise to research and identify new underpayment opportunities outside of technology enabled worklists. - Investigate reasons for discrepancies, such as payment variances, coding errors, billing discrepancies, or incorrect application of payer policies. - 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. Qualifications - High school diploma or equivalent required. Requirements - Want to grow a career. - Have moderate 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. - Excellent verbal and written communication skills to convey complex information to individuals with minimal healthcare or claims background. Benefits - 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. 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.

Role Description As a Workers' Compensation Claims billing specialist at Revecore, you will: - Make high-volume, outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies, on behalf of our clients (hospitals and medical providers). - Investigate and resolve problem and/or denied workers' compensation claims. - Submit bills and proper documentation to the insurance company or appropriate payer, ensuring maximized payments to our clients (medical providers). - Review information/documentation provided by the payer to determine next steps if bills aren't paid correctly. - Participate in special projects to achieve goals and ensure client success. Responsibilities - Have a working knowledge of Microsoft Office (Word, Excel, Outlook). - Possess technical proficiency to work on multiple computer screens and software applications simultaneously. - Maintain strong performance in a fast-paced environment with productivity metrics. - Remain organized while multi-tasking. - Use critical thinking and problem-solving skills to find effective and efficient solutions. - Communicate clearly, both verbally and in writing. - Possess an investigative mindset. - Have experience with Coordination of Benefits and a general understanding of insurance billing (a plus, but not required). 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. Training Our comprehensive training begins on your first day and lasts 8-10 business days. It is led by instructors and incorporates interactive discussions and hands-on activities to accommodate diverse learning preferences. Success starts with training. That's why we ask all new team members to be fully present each day, participate actively, and remain on camera. Work at Home Requirements - A private, distraction-free environment to work from within your home. - On-camera presence: Being on camera is an essential part of our culture - it helps build trust, support collaboration, and strengthen team connections. - A secure internet connection. - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads. - Workspace area must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset). Requirements - Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check. - 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 - Wisconsin

Role Description As an Auto Claims Specialist at Revecore, you will make high-volume, outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies, on behalf of our clients (hospitals and medical providers). - Investigate and research details of an auto accident to determine the payer. - Make a high volume of outbound calls to patients, insurance company representatives, and attorneys. - Submit bills and proper documentation to the insurance company, ensuring maximized payments to our clients. - Determine follow-up steps and resubmit bills for additional payment if bills aren't paid correctly. - Contribute to your team with various denial reports, audits, and overall support. Qualifications - Working knowledge of Microsoft Office (Word, Excel, Outlook). - Technical proficiency to work on multiple computer screens and software applications simultaneously. - Ability to maintain strong performance in a fast-paced, high outbound call center environment with productivity metrics. - Organizational skills while multi-tasking. - Critical thinking and problem-solving skills to find effective and efficient solutions. - Clear communication skills, both verbally and in writing. - Experience with Coordination of Benefits and a general understanding of insurance billing (a plus, but not required). Requirements - A private, distraction-free environment to work from in your home. - On-Camera Presence: Being on camera is essential for building trust, supporting collaboration, and strengthening team connections. - A secure internet connection. - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads. - Workspace must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset). - Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check. Benefits - Paid training and incentive plans. - Medical, dental, vision, and life insurance benefits available on day 1. - Excellent work/life balance. - Employee Resource Groups build community and foster a culture of belonging and inclusion. - 401(k) contributions matched. - Career growth opportunities. - 12 paid holidays and generous paid time off.

Role Description As a Health Claims Specialist at Revecore, you will: - Bill and investigate health insurance claims to ensure maximum payment from insurance companies on behalf of our clients (hospitals and medical providers). - Investigate and research health insurance claims. - Follow up on unresolved claims to facilitate payment for commercial health, Medicare, and Medicaid. - Contribute to your team with various denial reports, audits, and overall support. Qualifications - Has experience researching and resolving claims for commercial health, Medicare, and Medicaid. - Knows how to file correct UB04's and 1500 HCFA's with subrogation information to payers for payment. - Familiarity with billing health insurance as part of auto accidents. - Conducts timely follow-up activities to determine claim status and collect and/or provide information to resolve the claim. - Experience working in EPIC. - 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. Requirements - A private, distraction-free environment to work within your home. - On-Camera Presence: Being on camera is an essential part of our culture. - A secure internet connection. - Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads. - Workspace area must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset). - Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check. - Must reside in the United States within one of the specified states. Benefits - Paid training and incentive plans. - Medical, dental, vision, and life insurance benefits available on day 1. - Excellent work/life balance. - Employee Resource Groups build community and foster a culture of belonging and inclusion. - 401(k) contributions matched. - Career growth opportunities. - 12 paid holidays and generous paid time off.

Role Description As Revecore’s Senior Director, Client Success, you will: - Manage Revecore’s most strategic and complex client relationships. - Ensure strong partnerships, oversee client performance, and lead recovery strategies for at-risk engagements. - Manage strategic client relationships and lead action plans when performance challenges arise. - Work closely with assigned executive sponsors, keeping them informed of client performance, risks, and opportunities. - Engage executive sponsors when executive involvement is needed. The Role: - Manage a portfolio of strategic and complex clients. - Serve as executive relationship owner for key client stakeholders. - Provide regular updates to assigned executive sponsors. - Engage executive sponsors when strategic support or escalation is needed. - Lead development and execution of action plans for at-risk clients. - Coordinate recovery strategies with Operations and leadership. - Track client health indicators within CSP or Salesforce. - Demonstrate Revecore value through strategic reporting. - Identify service expansion opportunities. - Mentor Directors and Client Success Managers. - Support long-term client retention through proactive partnership management. Qualifications - Minimum 6 years healthcare revenue cycle experience. - Experience managing large and complex client relationships. - Strong financial and operational analysis skills. - Executive-level communication skills. 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. - Must reside in the United States within one of the states listed below: - Alabama - Arkansas - 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 - Wisconsin Benefits - Comprehensive medical, dental, vision, and life insurance benefits from the start of your employment. - 12 paid holidays and flexible paid time off. - 401(k) contributions. - Employee Resource Groups that build community. - Career growth opportunities. - An excellent work/life balance.

Role Description As an Underpayment Analyst within our Revenue Integrity team, 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 working with stakeholders to resolve issues and optimize reimbursement processes while adhering to regulatory guidelines and organizational policies. Strong analytical skills, attention to detail, and problem-solving skills are essential in this role. 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 the 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. - Other duties as assigned. Qualifications - High school diploma or equivalent required. - Investigative and problem-solving skills to identify underpayments and discrepancies. - Knowledge of healthcare billing, coding, and reimbursement methodologies. - Strong analytical abilities to dissect complex guidelines and understand their implications on claims reimbursement. - Ability to navigate and interpret various payer policies, including Medicare, Medicaid, and Commercial insurance guidelines. - Detail-oriented approach to ensure accuracy in applying guidelines and documenting findings for audit and compliance purposes. - Effective communication skills to collaborate with internal teams, payers, and external stakeholders. - Experience with healthcare billing software and databases (EPIC, Cerner, Meditech). - Familiarity with legal and regulatory frameworks governing healthcare reimbursement, such as HIPAA, CMS regulations, and state-specific requirements. - Moderate computer proficiency including MS Excel, Word, and Outlook. - Possess technical proficiency to work on multiple computer screens and software applications simultaneously. - Previous experience working in a remote environment. 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. Benefits - 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.