Revenue Specialist, Denials - Charles City, United States - EnableComp

Description

Recognized as a

2023 Top Workplace

by the

Tennessean , EnableComp is the leading source of revenue cycle management solutions for complex claims in the US.

We proudly partner with well over 1000+ hospitals across the US to help them maximize their revenue from complex claims.

Our Mission

We partner with healthcare providers to maximize reimbursement from complex claims payers by having the best people, processes, products and performance.

Our Vision
We enable healthcare providers to do what they do best.
Position Summary

The Revenue Specialist, Denials acts as the liaison between key client contacts and our denials appeal process to the appropriate payer.

The Revenue Specialist, Denials is responsible for the initial denial audit and activities to resolve outstanding claims.

This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.

Recognized as a

2023 Top Workplace

by the

Tennessean , EnableComp is the leading source of revenue cycle management solutions for complex claims in the US.

We proudly partner with well over 1000+ hospitals across the US to help them maximize their revenue from complex claims.

Our Mission

We partner with healthcare providers to maximize reimbursement from complex claims payers by having the best people, processes, products and performance.

Our Vision
We enable healthcare providers to do what they do best.
Position Summary

The Revenue Specialist, Denials acts as the liaison between key client contacts and our denials appeal process to the appropriate payer.

The Revenue Specialist, Denials is responsible for the initial denial audit and activities to resolve outstanding claims.

This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.

Key Responsibilities

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 and Qualifications

High School Diploma or GED required. Associates or Bachelor's Degree preferred.
1-2+ 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).

Regular and predictable attendance.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Special Considerations and Prerequisites

Practices and adheres to EnableComp's Core Values, Vision and Mission.
Proven ability to meet and/or exceed productivity targets and goals.
Maintains stable performance under pressure or opposition. Handles stress in ways to maintain relationships with all stakeholders.
Must be a self-starter and able to work independently without direct supervision.
Proven written and verbal communication skills.
Strong analytical and problem-solving skills.
Proven experience working with external clients; strong customer service skills and business acumen.
Ability to prioritize and manage multiple competing priorities and projects concurrently.
Must be able to remain in stationary position 50% of the time.
Occasionally moves about inside the office to access office equipment, etc.
Constantly operates a computer and other office equipment such as a copy/scan/print machine, phone and computer.

EnableComp is an Equal Opportunity Employer M/F/D/V.

All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status.

We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.

EnableComp recruits, develops and retains the industry's top talent.

As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people.

We believe that

investing in our employees is the key to our success , and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here.

At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies.

If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.

Don't just take our word for it Hear what our people are saying:
"I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other." – Revenue Specialist
"I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun." – Supervisor, Operations

Seniority level

Seniority level

Entry level
Employment type

Employment type

Full-time
Job function

Job function

Accounting/Auditing and Finance
Industries

Hospitals and Health Care
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