Operations Specialist

Our Company

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.

As part of our team, you’ll be rewarded with: 

• 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 

Location: Remote-US 

 

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.

 

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:

• 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

 

Education/Licensing/Certifications:

• High school diploma or equivalent required

 

Work Experience & Skills:

• 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

 

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.

  
Revecore is an affirmative action-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, 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 and Wisconsin   

 

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