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Revenue Specialist, Denials (REMOTE)

27 minutes ago
United States
Full-time
Senior
Accountant
Operations
Apply Now
EnableComp

EnableComp

EnableComp specializes in complex claims and specialty revenue cycle management solutions for healthcare providers, focusing on optimizing reimbursements for various claims types, including VA, Workers' Compensation, and Motor Vehicle Accidents, throug...

Insurance
251-1K
Founded 2000
View All Jobs 12

Description

  • Review denied and assigned claims using proprietary software, systems, and tools to determine correct reimbursement.
  • Analyze payer payment documentation and provider contract information to identify underpayments and claim issues.
  • Research, request, and submit medical records and supporting documentation with hospital claims to the appropriate payer.
  • Conduct timely phone follow-up with payers to confirm receipt of documentation and accelerate reimbursement.
  • Serve as a liaison between client contacts and the denials appeal process.
  • Handle patient health information (PHI) with strict privacy and security standards.
  • Perform other duties as required.

Requirements

  • High School Diploma or GED required; Associate’s or Bachelor’s degree preferred.
  • 5+ years of experience in healthcare billing or collections.
  • 1+ year of client-facing or customer service experience.
  • Intermediate knowledge of insurance payer/provider claims processing and related data requirements.
  • Strong computer proficiency, including MS Office Word, Excel, and Outlook.
  • Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology.
  • Strong understanding of the revenue cycle process and 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 payers process claims.
  • Intermediate understanding of EOBs, UB04 billing forms, and HCFA 1500 forms.
  • Strong ability to review client and payer contracts to identify complex underpayments.
  • Equivalent combination of education and experience will be considered.
  • Regular and predictable attendance required.
  • Ability to work independently, manage multiple priorities, and perform under pressure.

Benefits

  • Opportunity to work for a multi-award-winning, fast-growing healthcare revenue cycle company.
  • Professional growth and development support.
  • Tools, resources, and support to help employees thrive and grow their careers.
  • Flexible, family-oriented work culture.
  • Work-life balance emphasis.

Interested in this position?

Apply directly on the company website

Apply Now

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