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Rev Claims Jobs (NOW HIRING)

The AF Group

Medical Bill Rev Specialist I/II

Lansing, MI

$19 - $24.25/hr

SUMMARY Medical Bill Review Specialist I Primarily responsible for analyzing bills for multi-state Workers Compensation medical claims to determine appropriateness of services billed. Responsible for ...

Emergent Holdings

Medical Bill Rev Specialist I/II

Lansing, MI · On-site

$19 - $24.25/hr

SUMMARY Medical Bill Review Specialist I Primarily responsible for analyzing bills for multi-state Workers Compensation medical claims to determine appropriateness of services billed. Responsible for ...

CareSource

Payment Cycle Analyst II- Hybrid

Las Vegas, NV · On-site

$62K - $100K/yr

Demonstrated understanding of claims operations, configuration, and clinical editing specifically ... CPT, HCPC, REV, DRG and Rug * Knowledge of HIPAA Transaction Codes * Effective listening and ...

CareSource

Payment Cycle Analyst II- Hybrid

Las Vegas, NV · Hybrid

$62K - $100K/yr

... key Claims-related projects and initiatives. Essential Functions: Define clinical and payment ... HCPC, REV, DRG and Rug Knowledge of HIPAA Transaction Codes Effective listening and critical ...

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$72.1K

$118.5K

How much do rev claims jobs pay per year?

As of Jun 11, 2026, the average yearly pay for rev claims in the United States is $72,103.00, according to ZipRecruiter salary data. Most workers in this role earn between $50,000.00 and $89,000.00 per year, depending on experience, location, and employer.

What are some common challenges faced by professionals working in Rev Claims, and how can they be addressed?

Professionals in Rev Claims often encounter challenges such as navigating complex insurance policies, resolving denied or delayed claims, and keeping up with constantly changing healthcare regulations. Effective communication and attention to detail are crucial when collaborating with billing teams, healthcare providers, and insurance companies to ensure claims are processed accurately and efficiently. Staying current with industry updates and using specialized claims management software can help streamline workflows and reduce errors, ultimately improving claim resolution rates.

What is the difference between Rev Claims vs Rev Billing Specialist?

AspectRev ClaimsRev Billing Specialist
Required CredentialsMedical billing certification, knowledge of insurance claimsMedical billing certification, familiarity with billing software
Work EnvironmentHealthcare offices, insurance companiesMedical offices, billing departments
Employer & Industry UsageHealthcare providers, insurance companiesHospitals, clinics, billing companies
Common Search & ComparisonRev Claims vs Rev Billing Specialist

Rev Claims primarily focuses on submitting and managing insurance claims to ensure reimbursement, while Rev Billing Specialists handle the entire billing process, including invoicing and payment follow-up. Both roles require similar credentials and work in healthcare settings, but their specific responsibilities differ slightly, with Rev Claims centered on claims processing and Rev Billing Specialists managing broader billing tasks.

What are the key skills and qualifications needed to thrive as a Revenue Claims Specialist, and why are they important?

To thrive as a Revenue Claims Specialist, you need strong analytical abilities, knowledge of medical billing and coding, and a background in healthcare administration or a related field. Familiarity with claims management software, electronic health records (EHR), and certifications like Certified Professional Coder (CPC) are typically required. Attention to detail, problem-solving skills, and effective communication set top performers apart in this role. These skills ensure accurate claims processing, minimize revenue loss, and support compliance with industry regulations.

What are Rev Claims?

Rev Claims, short for Revenue Claims, refer to the processes and activities involved in submitting, tracking, and resolving claims for payment related to services rendered, typically within the healthcare or insurance industries. Professionals in Rev Claims roles are responsible for ensuring that accurate and timely claims are sent to payers, handling denials, and following up on outstanding payments. Their work is essential for maintaining a steady cash flow and ensuring that organizations receive appropriate reimbursement for their services.
More about Rev Claims jobs
What job categories do people searching Rev Claims jobs look for? The top searched job categories for Rev Claims jobs are:
Rev Claims jobs near you
Medical Bill Rev Specialist I/II

Medical Bill Rev Specialist I/II

The AF Group

Lansing, MI

$19 - $24.25/hr

Full-time

Posted 24 days ago

Job description

SUMMARY

Medical Bill Review Specialist I

Primarily responsible for analyzing bills for multi-state Workers Compensation medical claims to determine appropriateness of services billed. Responsible for analyzing simple billings by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes. Responsible for making bill review processing determinations according to rules, regulations, and/or third-party partners.

Medical Bill Review Specialist II

Primarily responsible for performing technical review of more complex medical bills, including modifiers, anesthesia, & psychiatric. Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software to determine appropriateness of codes and excessive charges. Also responsible for analyzing assigned medical bills to determine compliance with business rules, client specific requirements and multiple state rules, regulations and guidelines.

PRIMARY RESPONSIBILITIES include the following. Other duties may be assigned.

Medical Bill Review Specialist I:

Provides QA for basic bills for adjudication within Bill Review system.

Reviews, analyzes, adjusts and releases basic bills, including duplicates.

Refers to reference library of fee schedules, CPT, ICD-CM, HCPCS and other industry publications to support findings.

Assist all bill review teams as assigned with current work volumes or backlogs to ensure timely payments.

Identifies system and/or reports bill review issues and findings to MBR Leadership.

Provides a high level of customer service for all business partners and customers.

Reviews state reporting criteria as related to bill processing and outlined in state guidelines.

Manages confidential client information with discretion and good judgment in accordance with department and company guidelines.

Demonstrates a dependable work ethic.

Additional Responsibilities of Medical Bill Review Specialist II:

Responsible for analyzing complex billings for multi-state Workers Compensation medical claims to determine appropriateness of services billed.

Responsible for making bill review processing determination according to rules and regulations and or third-party partner.

Reviews hospital and surgery billings.

Reviews, analyzes, adjusts and releases queued bills to ensure timely payments.

Ensures provider compliance with the Workers Compensation Health Care Services Rules and Fee Schedule.

Process reconsiderations where no previous payment has been issued.

EDUCATION AND EXPERIENCE

Medical Bill Review Specialist I:

1. High School Diploma or G.E.D is required.

2. Minimum of two years of experience in a medical billing and/or coding position or similar relevant experience that would provide the necessary skills, knowledge and abilities to perform the required responsibilities.

Medical Bill Review Specialist II:

1. High School Diploma or G.E.D is required.

2. Degree/Certificate of completion in Medical Coding or Billing is required.

3. Minimum of one year as a Medical Bill Review Specialist I

OR

Minimum of two years demonstrated experience in workers compensation medical bill review analysis/pricing.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OTHER SKILLS AND ABILITIES

Medical Bill Review Specialist I:

Basic knowledge of medical terminology, anatomy, and CPT/ICD-CM codes, & medical fee schedule.

Basic knowledge of computers and ability to enter alpha/numeric data accurately.

Math skills with the ability to use a ten-key calculator.

Effective oral, written and communication skills.

Ability to consistently meet or exceed daily production and quality standards for this position. Ability to use reference manuals and apply information to medical claims

Excellent organizational skills and ability to prioritize work.

Ability to work with minimal direction.

Additional Skills and Abilities of Medical Bill Review Specialist II:

Knowledge of various state workers' compensation medical payment methodologies.

Demonstrated attention to detail.

ADDITIONAL INFORMATION

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment.

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