Remote Underpayment Analyst, Revenue Integrity

Openkrill; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Revecore is seeking an Underpayment Analyst to join the Revenue Integrity team. You will review hospital claims to verify reimbursement accuracy, investigate discrepancies, and collaborate with payers to optimize payments while adhering to regulatory guidelines.

Our comprehensive training begins on day one and spans 90 business days, led by instructors with hands-on activities to accommodate diverse learning styles. Remote work is supported where allowed.

Qualifications

• Strong investigative and problem-solving skills to identify underpayments and discrepancies.
• Knowledge of healthcare billing, coding, and reimbursement methodologies.
• Strong analytical abilities to interpret guidelines and their impact on claims reimbursement.
• Ability to navigate payer policies, including Medicare, Medicaid, and Commercial guidelines.
• Detail-oriented approach to ensure accuracy in applying guidelines and documenting findings for audits.
• Effective communication to collaborate with payers and internal teams.
• Experience with healthcare billing software and databases (EPIC, Cerner, Meditech).
• Familiarity with HIPAA, CMS regulations, and state-specific requirements.
• Moderate computer proficiency including MS Excel, Word, and Outlook.
• Previous experience working in a remote environment.

Responsibilities

• Identify discrepancies between expected reimbursement and actual reimbursement amounts.
• Investigate reasons for discrepancies, such as payment variances, coding errors, or billing discrepancies.
• 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.
• 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.

Skills

Investigative skills

Problem-solving

Healthcare billing knowledge

Coding & reimbursement methodologies

Payer policy navigation

Detail-oriented

Communication skills

Billing software experience

HIPAA/CMS familiarity

MS Excel/Word/Outlook

Remote work experience

Education

High school diploma or equivalent

Tools

EPIC

Cerner

Meditech

MS Excel

Outlook

Job description

Revecore is seeking an Underpayment Analyst to join the Revenue Integrity team. You will review hospital claims to verify reimbursement accuracy, investigate discrepancies, and collaborate with payers to optimize payments while adhering to regulatory guidelines.

Our comprehensive training begins on day one and spans 90 business days, led by instructors with hands-on activities to accommodate diverse learning styles. Remote work is supported where allowed.