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Revenue Specialist, Denials

3 hours, 57 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 and evaluate denied and assigned claims using EnableComp systems and tools.
  • Analyze payer payment documentation and provider contracts to determine accurate reimbursement.
  • Research and obtain medical records and supporting documentation for claims appeals.
  • Submit complete claims and documentation to appropriate payers.
  • Conduct timely telephone follow-up with payers to confirm receipt and facilitate reimbursement.
  • Protect patient health information and maintain confidentiality and data security.
  • Meet productivity targets while managing multiple priorities independently.

Requirements

  • High school diploma or GED required; associate or bachelor’s degree preferred.
  • 5+ years of healthcare billing or collections experience.
  • 1+ year of client-facing or customer service experience.
  • Intermediate knowledge of insurance payer and provider claims processing.
  • Understanding of ICD, HCPCS/CPT coding, and medical terminology.
  • Strong understanding of the healthcare revenue cycle and hospital reimbursement.
  • Knowledge of managed care contracts, contract language, and federal and state requirements.
  • Familiarity with HMO, PPO, IPA, capitation, EOBs, UB-04, and HCFA 1500 forms.
  • Strong computer proficiency, including Microsoft Word, Excel, and Outlook.
  • Strong written and verbal communication, analytical, problem-solving, customer service, and organizational skills.

Benefits

  • Professional growth and development support, including tools, resources, and career support.
  • Flexible, family-oriented culture supporting work-life balance.
  • Equal opportunity workplace committed to inclusion and a harassment-free environment.

Interested in this position?

Apply directly on the company website

Apply Now

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