Remote Revenue Integrity Analyst

OpenKrill; United States; On-site; USD 60,000 - 85,000; Full time

Job summary

Revecore is seeking an Underpayment Analyst within the Revenue Integrity team to ensure hospitals receive accurate compensation for services provided. You will examine hospital claims, resolve discrepancies, and optimize reimbursement processes while adhering to regulatory guidelines and company policies.

The role requires strong analytical and problem-solving skills, experience with payer policies and healthcare billing software, and the ability to work remotely across multiple stakeholders.

Qualifications

• Investigative and problem-solving skills to identify underpayments and discrepancies.
• Knowledge of healthcare billing, coding, and reimbursement methodologies.
• Strong analytical abilities to dissect complex guidelines and understand their implications on claims reimbursement.
• Ability to navigate and interpret payer policies including Medicare, Medicaid, and Commercial.
• Detail-oriented approach to ensure accuracy in applying guidelines and documenting findings for audit and compliance.
• Effective communication with internal teams, payers, and external stakeholders.
• Experience with healthcare billing software and databases (EPIC, Cerner, Meditech).
• Familiarity with HIPAA, CMS regulations, and state-specific requirements.

Responsibilities

• Identify discrepancies between expected and actual reimbursements using internal tools and best practices.
• Investigate reasons for underpayments such as payment variances or coding errors.
• Contact insurance companies to obtain missing information and resolve underpayments.
• Prepare and submit correspondence and payment postings with accuracy.
• Document root causes, trends, and outcomes to support continuous improvement.

Skills

Investigative skills

Healthcare billing

Analytical abilities

Payer policies

Communication

Multi-screen workflow

HIPAA regulations

Excel/Office

Education

High school diploma or equivalent

Tools

EPIC

Cerner

Meditech

Job description

Revecore is seeking an Underpayment Analyst within the Revenue Integrity team to ensure hospitals receive accurate compensation for services provided. You will examine hospital claims, resolve discrepancies, and optimize reimbursement processes while adhering to regulatory guidelines and company policies.

The role requires strong analytical and problem-solving skills, experience with payer policies and healthcare billing software, and the ability to work remotely across multiple stakeholders.