EnableComp provides specialty revenue cycle management solutions for healthcare organizations, helping hospitals, health systems, and ambulatory surgery centers improve financial sustainability through intelligent automation and expert human support.
The Resolution Analyst serves as a liaison between client contacts and the denials/underpayment appeal process with payers. This role focuses on reviewing denied and underpaid claims, supporting reimbursement recovery efforts, and helping improve revenue for assigned clients while handling protected health information securely.
Requirements & Qualifications
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+ year of client-facing or customer service experience
- Intermediate understanding of insurance payer/provider claims processing and related data requirements
- Strong computer proficiency, including Microsoft Word, Excel, and Outlook
- Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology
- Strong understanding of the revenue cycle process
- Working knowledge of hospital reimbursement, managed care contracts, contract language, and federal/state requirements
- Familiarity with HMO, PPO, IPA, and capitation terms and how payers process claims
- Intermediate understanding of EOBs, UB-04 hospital billing forms, and HCFA 1500 forms
- Ability to review client and payer contracts to identify complex underpayments
- Strong written and verbal communication skills
- Strong analytical, problem-solving, and customer service skills
- Ability to prioritize multiple competing projects
- Must be a self-starter and able to work independently
- Must be able to maintain regular and predictable attendance
Physical Requirements
- Must be able to remain in a stationary position 50% of the time
- Occasional movement within the office to access equipment
- Constant use of a computer and office equipment
Location
N/A
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago