Revecore

Analyst

• Examine hospital claims to verify proper reimbursement
• Identify discrepancies between expected and actual insurance-carrier reimbursement using company best practices, technology-enabled worklists, and internal tools
• Investigate payment variances, coding errors, billing discrepancies, and incorrect payer-policy application
• Contact insurance companies to obtain missing information, explain and resolve underpayments, and arrange payment or adjustment processing for clients
• Prepare and submit letters, emails, faxes, online inquiries, appeals, adjustments, reports, and payment postings
• Maintain documentation of underpayment root causes, trends, outcomes, and lessons learned
• Participate in discussions, meetings, and brainstorming sessions to improve processes
• Uphold ethical standards and comply with relevant regulations and organizational policies
• Perform other duties as assigned

Variance Underpayment Analyst

General

• Update patient accounts with information received from hospitals
• Follow up with Contact Specialist
• Access client connections and computer systems to obtain information required to update accounts
• Monitor requests to ensure they do not age beyond the required timeframe
• Perform special projects or assigned tasks
• Assist IT in resolving access issues
• Serve as a liaison between claims representatives and providers
• Facilitate timely resolution of client accounts

Information Request Specialist

Vice President

• Understand assigned clients’ businesses and underlying KPIs
• Retain existing revenue and business
• Identify, negotiate, and close cross-sell and up-sell opportunities
• Maintain client satisfaction, high NPS, and top industry rankings such as KLAS
• Represent the client voice to Product Development, Client Success, Legal, Implementations, and Operations
• Meet annual revenue retention and cross-sell/up-sell quota goals
• Establish trusted-advisor relationships with assigned clients around Revenue Cycle trends and reimbursement opportunities
• Understand, communicate, and address client needs
• Advise clients on healthcare trends, vendor consolidation, health system M&A activity, and revenue cycle news
• Collect and analyze industry behavior data
• Develop client-specific upsell strategies using roadblocks, competitor intelligence, budgets, renewal timelines, and service-line adoption pathways
• Build knowledge of current service lines and remove unnecessary scope exceptions
• Establish quarterly business and executive reviews

VP, Client Engagement

Claims Specialist

• Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies on behalf of hospitals and medical providers
• Investigate and research auto accident details to determine the payer
• Make outbound calls to patients, insurance company representatives, and attorneys
• Submit bills and proper documentation to insurance companies
• Ensure maximized payments to medical-provider clients
• Determine follow-up steps and resubmit incorrectly paid bills for additional payment
• Contribute to denial reports, audits, and overall team support
• Maintain accuracy and productivity standards while managing high-volume calls

Auto Claims Specialist

• Investigate health insurance claims and bills to ensure claims resolution
• Follow up on unresolved claims
• Facilitate payment of claims for Veterans' Affairs and its affiliates
• Complete comprehensive initial training and participate actively with camera on
• Maintain productivity and accuracy in a high-volume inbound and outbound call environment
• Work with multiple computer screens and software applications simultaneously

VA Claims Specialist

• Investigate health insurance claims and bills to ensure claims resolution
• Follow up on unresolved claims
• Facilitate payment of claims for Veterans' Affairs and its affiliates
• Attend and actively participate in comprehensive instructor-led training
• Maintain full focus during scheduled work hours while meeting productivity metrics
• Work actively on camera as part of the company culture
• Manage a high volume of inbound and outbound calls while maintaining accuracy and productivity standards

Operations

• Coordinate between operations and Revecore’s clients to complete agreed client tasks
• Obtain necessary documents, information, and account placements
• Maintain and facilitate working relationships to positively impact claims resolution
• Promptly resolve client and Revecore operations phone calls and emails, with an initial reply within 24 hours
• Use internal tools effectively to resolve client needs and reduce questions sent to clients
• Escalate applicable items to the CS VP
• Participate in monthly or quarterly client calls to facilitate rapport and processes
• Navigate healthcare software systems to complete agreed tasks, including Close & Return, New Insurance, Timely Filing, Reconciliation, ICD-10 Code Sweep Report, and Work Queues
• Coordinate with client staff to resolve requests and obtain documentation to progress accounts
• Organize and maintain current documentation regarding client access and client-specific protocols and processes
• Assist in training new COSs during onboarding
• Maintain internal documentation of specific client processes

Client Operations Specialist

Customer Success Manager

• Manage Revecore’s most strategic and complex client relationships
• Serve as executive relationship owner for key client stakeholders
• Oversee client performance and lead recovery strategies for at-risk engagements
• Provide regular updates to assigned executive sponsors
• Engage executive sponsors when strategic support or escalation is needed
• Lead development and execution of action plans for at-risk clients
• Coordinate recovery strategies with Operations and leadership
• Track client health indicators within CSP or Salesforce
• Demonstrate Revecore value through strategic reporting
• Identify service expansion opportunities
• Mentor Directors and Client Success Managers
• Support long-term client retention through proactive partnership management

Senior Director, Client Success

• Update patient accounts with information received from hospitals
• Follow up with Contact Specialist
• Access client connections and computer systems to obtain information needed to update accounts
• Monitor requests to ensure they do not age beyond the required timeframe
• Facilitate timely resolution of client accounts for assigned clients
• Act as liaison between claims representatives and providers
• Perform special projects or assigned tasks
• Assist IT in resolving access issues

• Update patient accounts with information received from hospitals
• Follow up with Contact Specialists
• Access client connections and computer systems to obtain information needed to update accounts
• Monitor requests to ensure they do not age beyond the required timeframe
• Perform special projects or assigned tasks
• Assist IT with resolving access issues
• Provide high-level service to facilitate timely resolution of client accounts
• Act as a liaison between claims representatives and providers

• Investigate health insurance claims and bills to ensure claims resolution
• Follow up on unresolved claims
• Facilitate payment of claims for Veterans' Affairs and its affiliates
• Attend comprehensive instructor-led training with interactive discussions and hands-on activities
• Participate actively in training and remain on camera
• Manage high-volume inbound and outbound calls
• Meet individual productivity and performance metrics

• Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims
• Investigate and resolve troubled and/or denied workers' compensation claims
• Contact patient employers, insurance company representatives, attorneys, and patients
• Submit bills and proper documentation to insurance companies or appropriate payers
• Ensure maximized payments to hospital and medical-provider clients
• Review payer information and documentation when bills are not paid correctly
• Determine next steps for incorrectly paid or unpaid bills
• Participate in special projects to achieve team goals and ensure client success
• Attend and actively participate in 8-10 business days of on-camera training

Customer Operations – Workers Compensation Claims

• Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims for hospital and medical-provider clients
• Investigate and resolve troubled or denied workers' compensation claims
• Contact patient employers, insurance company representatives, attorneys, and patients
• Submit bills and proper documentation to insurance companies or appropriate payers
• Review payer information and documentation when bills are not paid correctly and determine next steps
• Participate in special projects to achieve goals and ensure client success
• Remain present, participate actively, and stay on camera during training

• Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims for hospitals and medical providers
• Investigate and research auto accident details to determine the payer
• Make outbound calls to patients, insurance company representatives, and attorneys
• Submit bills and proper documentation to insurance companies
• Ensure maximized payments to medical-provider clients
• Determine follow-up steps and resubmit bills for additional payment when bills are not paid correctly
• Contribute to denial reports, audits, and overall team support
• Maintain productivity and accuracy metrics in a high-volume call-center environment

• Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies on behalf of hospitals and medical providers
• Investigate and resolve troubled and/or denied workers' compensation claims
• Contact patient employers, insurance company representatives, attorneys, and patients
• Submit bills and proper documentation to insurance companies or appropriate payers
• Review payer information and documentation when bills are not paid correctly to determine next steps
• Participate in special projects to achieve goals and ensure client success