Jobs at Revecore

Receive and process incoming mail and documents (paper, fax, electronic), identify patient information, create or update patient records, scan and attach documents, meet production and QA standards, maintain PHI confidentiality, and perform related special projects.

Lead AI, automation, and UX roadmap for Complex Claims platform. Drive discovery, data analysis, user stories, system mapping, UAT, and cross-functional delivery. Mentor PMs and align stakeholders to improve operational efficiency and financial outcomes.

As a Workers' Compensation Claims billing specialist, you'll make outbound calls to maximize payments on medical claims, investigate, and resolve billing issues while ensuring accurate documentation to insurance companies.

Supervise the Workers' Compensation team, manage performance and disciplinary actions, meet department benchmarks, train new hires, monitor quality/productivity, review denial requests, analyze accounts, recommend process improvements, communicate with clients, and maintain PHI confidentiality.

Make high-volume outbound calls to investigate, bill, and resolve denied or problem workers' compensation medical claims. Submit bills and documentation to payers, follow up on denials, coordinate with employers, insurers, attorneys and patients, meet productivity metrics, participate in special projects, and complete required training.

Supervise an Auto Claims team to meet revenue and production goals. Train, coach, and develop staff; review productivity reports and audits; manage denials and provider requests; coordinate with senior management; ensure PHI confidentiality; perform QA reviews, special projects, and daily revenue tracking to optimize process efficiency.

Make high-volume outbound calls to investigate auto accidents, identify the responsible payer, submit bills and documentation to insurers, follow up on denials, and perform audits and reporting to maximize medical claim payments for provider clients.

Review and manage third-party liability claims and litigation transfers, assess accounts for lien filing, communicate with attorneys and insurance adjusters, send bills/liens, track settlements and timely-filing deadlines, and transfer accounts to litigation team members as appropriate.

Design, build, and maintain scalable data lakehouse platforms and ELT pipelines. Improve engineering practices, develop automation/tooling, monitor performance, reduce costs, and support platform modernization across Azure and cloud data technologies.

Process Colorado Medicaid applications (Long Term Care, MAGI, Non-MAGI) using CBMS and company systems; manage caseloads, document cases, attend compliance/state trainings, follow HIPAA, meet accuracy and performance targets, travel to trainings/facilities, and provide customer service to secure medical coverage for uninsured and underinsured clients.

Make high-volume outbound calls to investigate auto accidents, identify payers, submit medical claims and documentation to insurers, follow up on denials, resubmit for additional payments, and support audits and denial reports to maximize provider payments.

Lead end-to-end ML system development: data exploration, model research, training, deployment, evaluation, and MLOps. Collaborate cross-functionally to prioritize claims, improve matching, measure business impact, and own a technical workstream.

The VA Claims Specialist investigates health insurance claims to ensure resolution, follows up on unresolved claims, and facilitates payments for Veterans' Affairs.

Design, implement, and maintain scalable, secure multi-cloud infrastructure (Azure and AWS) using IaC; build and optimize CI/CD pipelines; automate operations and database deployment; implement observability and security controls (HIPAA/SOC2); lead incident response and mentor engineers.

The Denials Recovery Analyst reviews managed care contracts, evaluates denied claims, calculates reimbursements, and maintains communication with clients and payors, ensuring efficient claims processing.