Revenue Specialist, OSM

1 week 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
201-500
Founded 2000

Description

  • Verify patient eligibility and authorization requirements as needed.
  • Analyze Medicaid claim payments against applicable state fee schedules and payer documentation.
  • Research, obtain, and submit medical records and supporting documentation with hospital claims.
  • Review and correct UB-04 technical billing components in accordance with billing laws.
  • Prepare and submit Medicaid initial billing packets using EnableComp systems and tools.
  • Follow up with payers by phone to confirm receipt of claims and supporting documentation and expedite reimbursement.
  • Monitor assigned account delinquencies and activity to secure timely, accurate payer payments.
  • Appeal claim denials and underpayments when necessary.
  • Manage inbound and outbound calls and collaborate with the team to move work through the department.
  • Handle confidential documentation and PHI in compliance with HIPAA guidelines.

Requirements

  • High school diploma or GED required; associate’s 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 required.
  • Experience with CMS-1500 billing and other complex claims is a plus.
  • Intermediate understanding of insurance payer/provider claims processing and related data requirements.
  • Understanding of Medicaid payers preferred.
  • Proficiency with MS Office, including Word, Excel, and Outlook.
  • Ability to meet productivity targets, work independently, and manage competing priorities.
  • Strong written and verbal communication, analytical, problem-solving, and customer service skills.

Benefits

  • Professional growth and career development support.
  • Access to tools, resources, and support to help employees succeed.
  • Collaborative, team-oriented work environment.
  • Flexible, family-oriented culture that supports work-life balance.

Interested in this position?

Apply directly on the company website

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