Underpayment Analyst

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.

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 work 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.

Training:

Our comprehensive training begins on your first day and lasts 90 business days. It is led by instructors and incorporates interactive discussions and hands-on activities to accommodate diverse learning preferences.

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 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

Education/Licensing/Certifications:

• High school diploma or equivalent required