Our Company
Start your next chapter at Revecore! For over 25 years, Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We're powered by people, driven by technology, and dedicated to our clients and employees. If you're looking for a collaborative and diverse culture with a great work/life balance, look no further.
Why Revecore?
- We offer paid training and incentive plans
- Our medical, dental, vision, and life insurance benefits are available on day 1
- We enjoy excellent work/life balance
- Our Employee Resource Groups build community and foster a culture of belonging and inclusion
- We match 401(k) contributions
- We offer career growth opportunities
- We celebrate 12 paid holidays and generous paid time off
Pay: $15/hr + Incentive Plan
The Health Eligibility Specialist is responsible for investigating and verifying health insurance coverage that was not successfully validated through automated processes. This role reviews insurance leads, research potential coverage sources, verifies eligibility and benefits, and ensures accurate insurance information is added to patient accounts in a timely manner. The specialist supports reimbursement efforts by identifying active coverage, resolving eligibility discrepancies, and maintaining compliance with departmental workflows, productivity standards, and client requirements.
Responsibilities
- Review assigned accounts and investigate potential insurance coverage sources using payer portals, eligibility tools, account documentation, and external resources
- Verify health and government payer eligibility through automated systems, online payer portals, IVR systems, vendor access tools, and outbound phone calls
- Research and validate insurance leads that were not successfully confirmed through automation processes
- Accurately add newly identified or verified insurance coverage to patient accounts in accordance with departmental procedures
- Review and resolve discrepancies related to eligibility, subscriber information, coverage dates, coordination of benefits, or payer information
- Maintain productivity, quality, and accuracy standards established by department leadership
- Properly document all account activity and eligibility findings within the appropriate systems
- Respond to internal requests regarding eligibility verification and account updates within established turnaround expectations
- Escalate complex account or payer issues to leadership as appropriate
- Maintain confidentiality of Protected Health Information (PHI) and comply with HIPAA regulations and company policies
Qualifications
- Ability to communicate effectively
- Attention to detail in essential to guarantee accuracy of work performed
- Demonstrated ability to adapt to a flexible workload, changing work focus and situational demands
- Willingness to work closely with others in a team environment
- Detailed understanding of other MRA departments in relation to own department
- Working knowledge of computer functions including; use of the internet, computer skills necessary to utilize web-based tools, and computer software programs to manage the workload. (i.e. AcciClaim, Emdeon, Passport, Availity…)
- High School Diploma or equivalent required
- One year of experience in a professional office environment
- Experience with eligibility verification or coordination of benefits is a plus, but not required
How we'll set you up for success
- Extensive multi-week training with ongoing support from teammates following training
- Access to a robust knowledgebase for continued reference in your role
- Visibility to your individual performance metrics enables you to set goals
- Computers and necessary work equipment are provided
- Involved management who leans in to support your productivity metrics
Training
Our comprehensive training begins on your first day and lasts 8-10 business days. It is led by instructors and incorporates interactive discussions and hands-on activities to accommodate diverse learning preferences. Success starts with training. That's why we ask all new team members to be fully present each day, participate actively, and remain on camera.
Work at Home Requirements
- A private, distraction-free environment to work from within your home
- On-camera presence: Being on camera is an essential part of our culture - it helps build trust, support collaboration, and strengthen team connections
- A secure internet connection
- Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads
- Revecore will provide you with your equipment - your workspace area must accommodate all workstation equipment (laptop, monitor, keyboard, mouse, docking station, and headset)
- Employment is contingent upon eligibility to work in the U.S., employment history verification, and a background check.
Revecore is an affirmative action-equal opportunity employer that does not discriminate based on 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.
Must reside in the United States within one of the states listed below:
Alabama, Arkansas, Connecticut, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia and Wisconsin
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Revenue Operations