Revenue Specialist

🕒 September 8

🎸 Tennessee – Remote

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⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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Logo of EnableComp

EnableComp

501 - 1000 employees

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Venture Round on 2022-07

Consulting • Insurance • Logistics

EnableComp is a company that specializes in revenue cycle management (RCM) for healthcare providers and health systems across the United States. They focus on processing complex claims related to Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid, as well as denial management for all payer classes. By leveraging intelligent automation and their proprietary E360 RCM™ platform, EnableComp helps healthcare providers increase revenue, control costs, and streamline billing processes. With expertise in handling complex claims, the company ensures accurate and timely reimbursement, providing significant uplift to collections and improving the financial performance of its clients.

📋 Description

• Verify patient eligibility when needed • Analyze and evaluate Medicaid claim payments using company systems and tools • Determine reimbursement compliance with applicable state fee schedules • Research, request, and acquire medical records and supporting documentation • Submit hospital claims with required documentation for prompt reimbursement • Review and correct UB-04 billing components in accordance with billing laws • Conduct telephone follow-up with payers regarding claims and documentation • Prepare and submit Medicaid initial bill packets with supporting documentation • Analyze account delinquencies and activity to ensure timely, accurate payments • Verify or request authorizations and assist with concurrent review activities • File and manage confidential documentation and PHI while following HIPAA guidelines • Manage inbound and outbound calls • Help move work efficiently through the department as part of a team • Appeal claim denials and underpayments • Perform other duties as required

🎯 Requirements

• High School Diploma or GED required • Associates or Bachelor’s Degree preferred • 1-2+ years’ experience in healthcare billing or collections • 1+ years’ client-facing/customer service experience • 1+ years’ experience with UB-04 billing and collections required • CMS-1500 billing and other complex claims experience a plus • Intermediate understanding of insurance payer/provider claims processing and related data requirements • Intermediate understanding of Medicaid payers preferred • Equivalent combination of education and experience will be considered • Strong computer proficiency and basic office applications knowledge, including MS Office (Word, Excel, and Outlook) • Regular and predictable attendance • Ability to meet or exceed productivity targets and goals • Ability to maintain stable performance under pressure • Self-starter able to work independently without direct supervision • Proven written and verbal communication skills • Strong analytical and problem-solving skills • Experience working with external clients; strong customer service skills and business acumen • Ability to prioritize and manage multiple competing priorities and projects concurrently • Ability to remain in a stationary position 50% of the time • Ability to operate a computer and office equipment continuously • Must handle PHI in accordance with HIPAA privacy and security requirements

🏖️ Benefits

• Full-time employment • Professional growth and development opportunities • Tools, resources, and support for career growth • Flexible, family-oriented work environment • Work-life balance support • Remote work option • Equal opportunity workplace free from discrimination and harassment

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