Health Claims Specialist

Revecore • Remote (US) • $15 / hour • 1m ago

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 plans
Our medical, dental, vision, and life insurance benefits are available from the first day of employment
We enjoy excellent work/life balance
Our Employee Resource Groups build community and foster a culture of belonging and inclusion
We match 401(k) contributions
We offer career growth opportunities
We celebrate 12 paid holidays and generous paid time off

The Role:

Investigates health insurance claims and bills to ensure claims resolution. Follows-up on unresolved claims and facilitates payment of claims for commercial health, Medicare, and Medicaid.

Essential Duties and Responsibilities

Researches and resolves claims for commercial health, Medicare, and Medicaid.
Files correct UB04’s and 1500 HCFA’s with subrogation information to payers for payment.
Prepares documentation to notify clients of action required to bill health insurance, Medicare or Medicaid.
Closes and returns claims to client upon resolution using correct text and procedures in regards to denial process.
Conducts timely follow-up activities to determine claim status and collect and/or provide information to resolve the claim.
Maintains proper account documentation in Needles.
Responds to email and phone correspondence per department guidelines.
Continues education and professional development by attending staff training, department Lunch and Learns, Revecore University, and attending Continuing Education Classes.
Assists 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 or tasks as assigned.
Maintain confidential information, whether verbal, written or electronic, which I will learn in the course of my work at Revecore..

Job Knowledge, Skills and Abilities Required

Ability to communicate effectively verbally and in writing.
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.
Must have a high level of attention to detail and be skilled in organizing and prioritizing work.
Demonstrated ability to work cooperatively and follow-through on assignments under minimal supervision.
Ability to work both commercial and government health claims.
Working knowledge of computer functions including the internet, and computer software such as Microsoft Office suite, Word Perfect; knowledge of or willingness to learn Needles.

Education and Experience Qualifications

High school diploma or equivalent required.
Experience handling a large volume of phone calls to collect information.
Eagerness to learn new technologies and develop proficiency in internal applications
Strong computer navigation skills and experience using multiple software programs simultaneously to complete work.
Ability to work in Eastern (EST) or Central (CST) time zone
Must reside in the United States within one of the states listed below:

Work at Home Requirements:

A quiet, distraction-free environment to work from in your home.
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.

Revecore is an equal opportunity employer that does not discriminate based on 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, Delaware, Florida, Georgia, Iowa, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Michigan, Minnesota, Missouri, Mississippi, Montana, North Carolina, Nebraska, New Hampshire, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Wisconsin, and West Virginia