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SalaryWe are an innovative, technology-driven company 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 opportunities 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, we want you on our team!
Why Join Revecore?
- Paid training and incentive plans depending on the role
- Medical, dental, vision, and life insurance benefits are available from the first day of employment.
- 401(k) with employer match after 90 days
- Career growth opportunities
- Generous PTO plan
- 12 paid holidays
- Computers and necessary work equipment are provided
Location: Remote - U.S.A.
The Role:
Workers Compensation Specialists are part of a purpose-driven team that resolves troubled and/or denied Workers Compensation Claims. This role acts as a patient advocate in securing the maximum payout from insurance companies, thereby lessening the responsibility of the injured worker, while ensuring maximum payout on behalf of the medical provider. A successful candidate will investigate the various nuances of a claim to quickly and accurately submit the applicable bills to a Work Comp insurer. While at the same time also reading, interpreting, and dissecting EOB’s, keeping up with state rules/guidelines to confidently address and correct any non-payment discrepancies with Work Comp insurance companies.
As a Work Comp Specialist, you will:
- Bill worker’s comp insurance carriers on behalf of medical providers (the client). Obtains and verifies claim information, accident details, carrier billing information, and necessary billing documents from medical providers.
- Review medical provider account notes and account history. Obtains accident details, employer contact information and worker’s comp carrier/claim information.
- Perform follow-up activities with employers, carriers, adjusters, and patients. Verifies bill is on file; verifies required documentation was received; and obtains bill processing status.
- Resolve regular, disputed, and denied accounts through communication with adjusters and patients. Reviews EOB’s, resolves medical coding issues and requests by requesting corrected UBs and appealing denials. Follows up with patients to obtain accident details, health insurance information and counsels’ patient on claims resolution upon request.
- Process denied claims (“Denials”). Reviews accounts as needed and returns them to clients with a detailed, written explanation for return.
- Have a team mentality! We encourage those who are more experienced to contribute advice and guidance to newer employees with tips and tricks.
- Proactively identifies systemic client issues, such as underpayments, service line issues, and reports these issues to department management.
- Perform follow-up activities with adjusters to verify receipt of appeal letters, obtain EOB’s, request bill review explanations and/or documentation, dispute charges, dispute contracts, obtain payment information, and provide supporting documentation to support appeal, applicable when working with High Dollar accounts.
- Perform special projects or tasks as assigned.
- Maintain confidential information, whether verbal, written or electronic, which you will learn in the course of my work at Revecore.
You will be successful if you have:
- Ability to communicate effectively verbally and in writing.
- Call center experience, customer service, and working under metrics.
- Ability to LEARN and RETAIN what you learn and put into practice.
- Analytical skills and the ability to MULTI-TASK
- 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.
- Working knowledge or ability to learn state workers’ compensation laws and regulations as assigned.
- Skilled in problem resolution and processing numerous types of denials.
- The ability to produce accurate work while maintaining attention to detail.
- Willingness to work cooperatively in a team environment.
- A high level of attention to detail and be skilled in organizing and prioritizing work.
- Basic knowledge of computer operation; working knowledge of Word, Excel, Outlook, and ability to create PDF’s.
- Experience processing Workers' Compensation claims on behalf of healthcare providers strongly preferred, but not required.
- An unnatural ability to put together 1,000-piece puzzles in record time.
- Solved every murder before the star of the latest CSI show on T.V..
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: (multiple states can be listed for remote roles, ideally in EST or CST)
Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Maryland, Michigan, Minnesota, Missouri, Mississippi, Montana, North Carolina, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Wisconsin, and West Virginia
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Not required, but preferred:
- At least one year of experience in a professional office environment.
- Experience with the Coordination of Benefits and Subrogation requirements
Work at Home Requirements:
- A quiet, distraction-free environment to work from in your home
- A reliable hard-wired private internet connection that is not supplied via cellular data or hotspot 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 on the basis of 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.
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.
