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.
VA Claims Specialist
Location
United States
Posted
5 days ago
Salary
$15 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
VA Claims Specialist
Revecore
Role Description The Role: VA Claims Specialist - Investigates health insurance claims and bills to ensure claims resolution. - Follows-up on unresolved claims and facilitates 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 and incorporates interactive discussions and hands-on activities to accommodate diverse learning preferences. Is this role for you? - Revecore encourages our employees to be driven and highly motivated to be successful. - Consider this role if you: - 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. - 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. - Have an unnatural ability to put together a 1,000 piece puzzle in record time. - Take pride in solving the mystery on a TV crime show before the main character. - Have at least one year of experience in a professional office environment; experience in health insurance billing preferred. - Have experience with Coordination of Benefits and a general understanding of insurance billing (a plus, but not required). - Have experience with billing and appealing denied health claims (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. 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 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. - Must reside in the United States within one of the states listed below: - Alabama - Arkansas - Delaware - Florida - Georgia - Iowa - Indiana - Kansas - Kentucky - Louisiana - Michigan - Minnesota - Missouri - Mississippi - Montana - North Carolina - Nebraska - Ohio - Oklahoma - Pennsylvania - Rhode Island - South Carolina - Tennessee - Texas - Virginia - Wisconsin - West Virginia 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. - Pay: $15/hr.
Related Guides
Related Categories
Related Job Pages
More Claims Specialist Jobs
Leave Specialist
Sparrow - TrySparrow.com, Inc.Sparrow, legally known as TrySparrow.com, Inc., is a software company that partners with employers to manage all types of employee leave, like family and medica
Role Description As a Leave Specialist, you will be the primary contact for employees of companies we service and will manage a leave of absence from start to finish. You will also play a critical role of supporting your peers and Sparrow team members. What your day to day will look like: - Manage a portfolio of leave of absences, short-term and long-term leaves, from inception to completion for employees in the US and Canada across multiple companies using established Leave of Absence processes. - Maintain ongoing knowledge of State, Federal, and an array of Company leave policies, including FMLA and ADA, short-term and long-term disability plans. You’ll be responsible for ensuring employees are aware of their responsibilities and reviewing eligibility, certification, and benefits. - Communicate directly with third parties when necessary, preserving the confidentiality of employee medical documentation and files. - Interface and collaborate comfortably with a variety of key stakeholders to maintain relationships, including employees, HR, payroll teams, managers, HR Business Partners, through various methods of communication (phone, email). - Maintain complete and accurate internal records of leave requests and documentation of best practices. - Partner with our internal payroll teams to ensure employees are paid accurately and on time. Includes building, analyzing, and communicating clear payroll information to employees and HR teams. - Partner with our internal claims management team to file and manage claim filings with states and private disability insurance providers. - Use a combination of tools to manage, communicate and update all stages of a leave. - Work with the Customer Experience department to ensure a consistent level of service, utilizing resources and adapting to process improvements to enhance employee and employer experiences. Maintain key metrics, including Service Level Agreements and Customer Satisfaction. - Actively participate in team meetings providing feedback, solutions and suggestions. Qualifications - Strong collaboration and communication skills that allow you to interact comfortably with internal cross-functional teams, and customers. - You excel in active listening, empathy, and approachability. - Be comfortable moving between multiple tasks in a quick succession. - Be adaptable to process and product improvements in a growing start-up. - Able to utilize resources to identify answers to common employee or employer questions about the leave process. - Maintains internal systems and processes. - Demonstrates strong customer service skills. Represents the company voice with customers, listens empathetically to understand customer needs and provides impactful solutions. - Understand and interpret basic payroll calculations with the ability to break down these calculations in an easy to understand manner. Requirements - Superior organization skills and detail-oriented. - Outstanding verbal and written communication skills. - Clear, empathetic communicator able to balance rapport and problem solving. Comfortable communicating through email, chat, and phone calls. - Remarkable degree of empathy and interpersonal intuition, and strong, active listening skills. More than 2 years of client-facing experience where relationship-building is valued. - Highly self-directed, adaptable, and up for feedback and implementation in a fast paced, always changing environment. - Proactive. Always anticipating what might come next and how better to support the Leave Specialist team. - Systems-oriented. Always thinking of how you can improve processes to make the team even more efficient. - Trustworthy. You act with discretion and can be trusted to handle confidential information appropriately. - Relentlessly Optimistic. You believe in and work for the possibility of change and are unyielded by uncertainty and roadblocks. - Empathetic. You lead with empathy, and understand each situation from our customers perspective and approach with compassion. Compensation This is a full-time hourly, non-exempt position. Compensation ranges from $22.25 to $27.50 per hour and is based on your legal state of residence. Benefits Our work at Sparrow is impactful. We help People teams with one of the hardest parts of their job, and we support employees at a time when they need it most. We’re driven by our mission, much like a nonprofit, but with the resources and scale of a fast-growing venture-backed company.
Role Description The Credentialing Specialist supports the provider credentialing and payer enrollment functions for multiple healthcare clients within the RCM organization. This role ensures that all providers are accurately credentialed and enrolled with Medicare, Medicaid, and commercial health plans to prevent claim denials and optimize reimbursement. The specialist serves as the main point of contact between providers, payers, and internal teams to maintain compliance and credentialing accuracy. Responsibilities - Manage end-to-end credentialing and recredentialing for providers across assigned client accounts. - Prepare, submit, and track payer enrollment and participation applications for Medicare, Medicaid, and commercial health plans. - Verify provider credentials, including licenses, NPI, DEA, malpractice, CAQH profiles, and board certifications. - Maintain detailed, organized records of all credentialing activities within internal databases and client systems. - Communicate with providers, payers, and internal teams to resolve credentialing issues or delays. - Proactively monitor upcoming expirations and initiate timely renewals to ensure continuous network participation. - Collaborate with the contracting and billing teams to align provider enrollment with payer contracts and claim submission readiness. - Stay current with payer policies, CMS, and NCQA credentialing standards to ensure compliance. - Generate credentialing status reports and provide updates to internal leadership and client contacts. Qualifications - Associate’s or Bachelor’s degree preferred (Healthcare Administration or related field). - Minimum 2 years of credentialing or provider enrollment experience, preferably with an RCM vendor or multi-client environment. - Familiarity with Medicare/Medicaid enrollment processes, PECOS, CAQH, and payer portals. - Strong organizational and documentation skills with attention to detail. - Excellent written and verbal communication. - Ability to manage multiple client accounts and deadlines simultaneously. - Proficient in Microsoft Office and credentialing/enrollment software. - CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) preferred but not required. Work Environment - Fast-paced, deadline-driven RCM vendor environment. - Remote work setting with cross-functional collaboration across clients, operations, and payer teams. - Must maintain confidentiality of provider and client data at all times.
Credentialing Specialist
Duly Health and CareDuly Health and Care, headquartered in Downers Grove, Illinois, is a physician-directed, multispecialty medical group founded in 1999 as DuPage Medical Group, w
Maintains confidential research required for effective credentialing processes intended to appropriately credential for onboarding of initial applicants and reappointment activities.
Credentialing Specialist
Banner HealthBanner Health is a nonprofit healthcare system based in Phoenix, Arizona. As one of the largest employers in the country, Banner Health utilizes the expertise and efforts of nearly
Title: Credentialing Specialist Location: Phoenix United States Job Description: Department Name: BH Central Verificatn Ofc-Corp Work Shift: Day Job Category: Clinical Support A rewarding career that fits your life. Learn how Banner Health, a certified Great Place To Work, prioritizes team members and strives to be the best place to work in health care. Banner Health has a great opportunity for a Credentialing Specialist in a high-volume Centralized Verification Office. This position supports the initial credentialing of providers for hospital membership and privileges, while working with a dynamic team supporting 30 hospitals in 6 states. The ideal candidate will understand industry requirements and be familiar with credentialing databases, as demonstrated through three years of credentialing experience. Generally Monday to Friday 8 am to 4:30 pm This is a remote position if you reside in Arizona or Colorado allowing you to work from home exclusively. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position performs the department's credentialing work as outlined in the policies and procedures. Obtains all primary source information necessary for all organizational facilities and entities. The incumbent maintains records and the integrity of highly confidential information that is protected from discovery by applicable state statutes. CORE FUNCTIONS - Performs the appropriate (applicable) credentialing processes in a timely and complete manner. - Performs analysis and appropriate follow-up. Works with many individuals to acquire necessary materials and information, including, but not limited to: physicians, facility staff, professional staff and physicians' office staff. - Performs relevant data entry into the database to ensure consistency and integrity of the data. - Processes appropriate queries for expired licensure, or any appropriate regulatory credentialing requirement and maintains documentation in the database. - The incumbent performs and completes activities within the parameters established by the director and supervisor and as outlined in the facility/entity documents. Manages own duties and functions independently. Work requires the constant exercise of a high degree of independent judgment in response to complex and sensitive credentialing issues, decision making and discretion. Uses independent decision making processes and handles assigned duties in a meaningful and confidential manner with a minimum of supervision. Handles physician inquiries and problems within the scope of job function and keeps supervisors apprised of all issues as they occur. Department and hospital responsibility. Internal customers include facility medical staff services, physicians, hospital personnel, corporate staff, hospital management, and volunteers. External customers include but are not limited to regulatory/accrediting and licensing agencies, legal entities, state and national databases, other hospitals and the general public. MINIMUM QUALIFICATIONS Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of an associate's degree. Must possess a strong knowledge and understanding of healthcare planning as normally demonstrated through three years of credentialing and/or process management and operations experience. Requires a basic knowledge of medical terminology, medical staff organization and extensive knowledge of credentialing procedures. Must have experience in interacting with physicians and allied health professionals, their office credentialing representatives, and hospital personnel. Must have excellent communication skills, both verbal and written, along with astute judgment in areas of human relations. Must demonstrate an ability to meet deadlines in a multi-functional task environment. Requires excellent organizational skills and operational knowledge working with work processing, spreadsheets, data entry, fax machines, and other computer related skills. Must, at all times, maintain efficiency and timeliness in all daily activities. Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process. Provides optimal customer service to meet the organization's expectations. PREFERRED QUALIFICATIONS National Certified Provider Credentialing Specialist (NCPCS) certification preferred. Additional related education and/or experience preferred. Estimated Pay Range: $21.01 - $31.51 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained. Anticipated Closing Window (actual close date may be sooner): 2026-09-17 EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy


