Revenue Specialist, OSM

3 weeks, 6 days ago
Full-time
Junior
Operations
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

Description

  • Verify patient eligibility and obtain required authorizations.
  • Analyze Medicaid payments against applicable state fee schedules.
  • Research and obtain medical records and supporting documentation for claims.
  • Review and correct UB-04 billing information in accordance with billing laws.
  • Prepare and submit Medicaid claim packets with required documentation.
  • Follow up with payers by phone to facilitate claim receipt and reimbursement.
  • Analyze delinquent accounts and activity to ensure timely, accurate payments.
  • Appeal claim denials and underpayments as needed.
  • Maintain confidential documentation and comply with HIPAA requirements.
  • Manage inbound and outbound calls while collaborating with the department team.

Requirements

  • High school diploma or GED required; associate or bachelor’s degree preferred.
  • 1–2+ years of healthcare billing or collections experience.
  • 1+ year of client-facing or customer service experience.
  • 1+ year of UB-04 billing and collections experience; CMS-1500 and complex claims experience preferred.
  • Intermediate knowledge of insurance claims processing and payer/provider data requirements.
  • Intermediate knowledge of Medicaid payers preferred.
  • Proficiency with Microsoft Office applications, including Word, Excel, and Outlook.
  • Strong written and verbal communication, analytical, and problem-solving skills.
  • Ability to work independently, meet productivity goals, and manage competing priorities.
  • Regular and predictable attendance; ability to remain stationary for approximately 50% of the workday.

Benefits

  • Professional growth and development support, including tools, resources, and career-building opportunities.
  • Flexible, family-oriented culture supporting work-life balance.
  • Collaborative workplace centered on employee empowerment and shared goals.
  • Equal opportunity employer committed to a discrimination- and harassment-free workplace.

Interested in this position?

Apply directly on the company website

Apply Now

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