Revenue Specialist, Denials

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🕒 July 22

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EnableComp

WebsiteLinkedInAll Job Openings

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

• Review and evaluate Denied and other assigned claims using EnableComp’s proprietary software, systems and tools • Use payment documentation provided by payers and medical provider contract information to determine the correct reimbursement • Research, request and acquire all pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to the appropriate payer to ensure prompt correct claims reimbursement • Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement • Other duties as required

🎯 Requirements

• High School Diploma or GED required • Associates or Bachelor’s Degree preferred • 5+ years’ experience in healthcare field working in billing or collections • 1+ years’ client facing/customer services experience • Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements • Equivalent combination of education and experience will be considered • Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook) • Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology • Strong understanding of the revenue cycle process • Full understanding of hospital reimbursement, Intermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements • Familiarity with HMO, PPO, IPA, and capitation terms and how these payors process claims • Intermediate understanding of EOB, hospital billing form requirements (UB04), and familiarity with the HCFA 1500 forms • Demonstrate strong ability to review client/payer contracts to identify complex underpayments • Regular and predictable attendance

🏖️ Benefits

• EnableComp is an Equal Opportunity Employer M/F/D/V • Committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment • Culture centered around fostering the professional growth and development of our people • Continuous commitment to investing in our employees’ success