EnableComp provides specialty revenue cycle management solutions for healthcare organizations, supporting hospitals, health systems, and ambulatory surgery centers nationwide.
The Revenue Specialist serves as the liaison between key client contacts and insurance companies. The role involves handling patient health information (PHI) and maintaining strict privacy and security standards.
Key responsibilities
- Analyze and evaluate workers' compensation claim payments using proprietary software, systems, and tools.
- Review payment documentation provided by payers to determine whether the medical provider has been reimbursed in compliance with the applicable state workers' compensation fee schedule and/or PPO contract.
- Research, request, and collect medical records, implant manufacturer invoices, and other supporting documentation, then submit them with hospital claims to insurance companies for prompt reimbursement.
- Conduct timely telephone follow-up with payers to confirm receipt of claims and supporting documentation and to help facilitate reimbursement.
- Prepare initial workers' compensation bill packets or appeal letters and submit them with all required documentation.
- Perform other duties as assigned.
Requirements & Qualifications
Qualifications
- High school diploma or GED required; associate's or bachelor's degree preferred.
- 1-2+ years of experience in the healthcare field working in billing or collections.
- 1+ year of client-facing or customer service experience.
- 1+ year of workers' compensation billing and collections experience preferred.
- Intermediate understanding of insurance payer/provider claims processing and related data requirements.
- Strong computer proficiency, including Microsoft Word, Excel, and Outlook.
- Equivalent combination of education and experience may be considered.
Additional expectations
- Proven ability to meet productivity targets and goals.
- Ability to stay calm under pressure and maintain strong stakeholder relationships.
- Self-starter who can work independently without direct supervision.
- Strong written and verbal communication skills.
- Strong analytical and problem-solving skills.
- Ability to prioritize and manage multiple competing tasks and projects.
- Must be able to remain in a stationary position for 50% of the time and operate a computer and office equipment regularly.
Location
Tennessee, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago
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