Claims Specialist Job at Revecore, Remote

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Job Description

Revecore is an innovative, technology-driven company that is committed to helping our clients, our employees, our company, and our communities thrive. An award-winning services firm, partnering with hospitals and health systems, providing the momentum they need to maintain a strong revenue cycle amid today’s evolving healthcare environment.
With a 20+ year history, Revecore is the leading provider of revenue integrity and complex claims solutions for hospitals.
We offer a dynamic and flexible work environment, full of opportunity for motivated, hands-on team players. We strive each day to solve complex business problems and find new ways to enhance the efficiency, effectiveness, and quality of our services. If those attributes resonate with you, regardless of where you are located—we want you on our team!
Location: Remote
Purpose
Investigates and coordinates no-fault benefits for accident claims from auto, home or other liability insurance policies. Resolves accounts as quickly and accurately as possible, obtaining maximum reimbursement.

Essential Duties and Responsibilities
  • Reviews and researches accident claims to investigate possible leads.
  • Coordinates insurance benefits for patients. Contacts patients, insurance representatives, and attorneys to verify relevant details and obtain maximum payments. Bills no-fault and TPL carriers when appropriate.
  • Requests documentation from insurance representatives when no no-fault insurance exists.
  • Closes and returns claims to client upon resolution using correct text and procedures in regards to denial process.
  • Maintains proper account documentation in AcciClaim.
  • Responds to email and phone correspondence per department guidelines.
  • Resolves any issues noted in the QA work reviews.
  • Continues education and professional development by attending staff training, department Lunch and Learns, Revecore University, and attending Continuing Education Classes.
  • Assists Team Leader with new employee training. Provides initial one-on-one training in position basics and best practices, and serves as a resource for new employees.
  • Completes special reports as required, such as aged reports, checklist audits, denial reports, etc.
  • Performs special projects as assigned.
  • Maintain confidential information, whether verbal, written or electronic, which I will learn in the course of my work at Revecore.
  • Will not access or attempt to access confidential data that is unrelated to my job duties in the course of my work at Revecore.
  • Will not disclose Protected Health Information (PHI) in violation of law.

Job Knowledge, Skills and Abilities Required
  • Ability to communicate effectively verbally and in writing. Proven ability to speak on a one-to-one basis with patients, attorneys and adjusters using appropriate vocabulary and grammar to explain what is required and obtain information.
  • Demonstrated ability to work independently and follow-through on assignments with minimal direction.
  • Must be able to pay attention to detail in order to produce accurate work, often under minimal supervision.
  • Proven ability to be assertive in order to proactively resolve issues.
  • Must be skilled in problem analysis and resolution.
  • Demonstrated ability to organize and set priorities according to situational demands.
  • Working knowledge of computer functions including the internet, and computer software such as Microsoft Office suite and Word Perfect; working knowledge of or ability to learn AcciClaim and SharePoint.

Education and Experience Requirements
  • High school diploma or equivalent required.
  • At least one year of experience in a professional office environment required; experience in health and/or auto insurance preferred.
  • Call center experience, customer service, and working under metrics is a plus.
  • Experience with Coordination of Benefits and Subrogation requirements is a plus.

Working Conditions/Environment/Physical Demands/Travel Required
  • High volume calls.
  • General office working conditions; sitting and using a computer and a telephone for long periods of time.
  • Protection from weather conditions but not necessarily from temperature changes.
  • Percentage of travel: negligible.
Why Join Revecore?
  • Fully remote work.
  • Medical, dental, vision, and life insurance benefits are available from the first day of employment.
  • 401(k) with employer match after 90 days.
  • Generous PTO plan
  • 12 paid holidays
  • All computer and necessary hardware are provided to you.
About Revecore
As a mulit-year award winning services team, we partner with hospitals and health systems to become a trusted advisor and extension of their billing office.
Our Revenue Integrity division, based out of Crescent Springs, KY and Cincinnati, OH, specializes in identifying, recovering, and preventing underpayments and denials from commercial and government payers. Our data-driven solutions are fueled by The Bridge, our proprietary technology that delivers actionable intelligence and our people allow us to leverage that technology to strengthen a hospital’s internal systems and prevent future losses.
Our Complex Claims division, based out of Franklin, TN, delivers reimbursement solutions that identify and recover overlooked revenue for hospitals and health systems nationwide. AcciClaim, our innovative technology platform seamlessly resolves accident-related medical claims, securing accurate reimbursement while eliminating the administrative pain of billing for Motor Vehicle and Workers’ Compensation accidents and Veterans Affairs Claims.

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