EnableComp provides specialty revenue cycle management solutions for healthcare organizations, using an intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers nationwide.
The Resolution Analyst serves as a liaison between client contacts and the denials and underpayment appeal process with payers. This role focuses on reviewing denied and underpaid claims, supporting payment recovery efforts, and helping increase revenue for assigned clients. The position also involves handling protected health information and maintaining strict privacy and security standards.
Requirements & Qualifications
Requirements and qualifications
- High school diploma or GED required; associate's or bachelor's degree preferred
- 5+ years of experience in the healthcare field working in billing or collections
- 1+ years of client-facing or customer service experience
- Intermediate understanding of insurance payer/provider claims processing and related data requirements
- Strong computer skills, including Microsoft Word, Excel, and Outlook
- Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology
- Strong understanding of the revenue cycle process
- Knowledge of hospital reimbursement, managed care contracts, contract language, and federal/state requirements
- Familiarity with HMO, PPO, IPA, and capitation terms
- Intermediate understanding of EOBs, UB-04 forms, and HCFA 1500 forms
- Ability to review client and payer contracts to identify complex underpayments
- Strong written and verbal communication skills
- Strong analytical and problem-solving skills
- Ability to prioritize and manage multiple competing priorities and projects
- Must be self-starter capable of working independently without direct supervision
- Proven ability to meet or exceed productivity targets and goals
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago
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