EnableComp, LLC
  • Revenue Services
  • Franklin, TN, USA
  • Full Time

Comprehensive Benefits package including 401k!

Our Mission

We partner with healthcare providers to maximize reimbursement from complex claims payers by having the best people, processes, products and performance.

Our Vision

We enable healthcare providers to do what they do best.

Position Summary

The Reimbursement Analyst is responsible for contract management and fee schedule research and development. This person acts as the liaison between Analytics, Managed Care and IT and is responsible for ensuring quality by continually testing rules, analyzing and implementing fee schedules, and producing summary documentation and training guides for end users. Collaborates with Training on the creation of training materials and courses.

Key Responsibilities

  • Work collaboratively with individuals from every facet of the operation, identifying and analyzing state fee schedule guides, creating effective SME documents, summarizing said rules and coordinating user testing to ensure reimbursement requirements are executed accurately
  • Identify and research reimbursement issues for individual state fee schedules and hospital and professional fee schedules
  • Work directly with the IT project team to identify and translate business requirements necessary for timely and accurate Fee Schedule coding, testing, and deployment
  • Monitor on-going changes for newly published fee schedule updates, as well as conduct periodic reviews to validate rules accuracy
  • Monitors system reminders, error logs, data integrity checks and anomalies in production data.
  • Update Fee Schedule rules and load data tables in a timely manner
  • Assist with the communication, training and document creation of relevant Fee Schedule updates
  • Use of independent judgement and discretion as it relates to responsibilities detailed above
  • Other duties as required

Requirements and Qualifications

  • Bachelor's Degree required
  • 3 years' experience with healthcare reimbursement analysis
  • Familiar with medical billing, claims and IT systems; proficient in Excel including pivot tables and v-lookup functions
  • Knowledge of hospital and professional coding and reimbursement methodologies required
  • Exposure to business logic creation and/or system programming a plus
  • Equivalent combination of education and experience will be considered
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions

Special Considerations and Prerequisites

  • Proven experience writing business requirements and/or creating business rule specifications for hospital and professional reimbursement fee schedules, understanding of Medicare reimbursement methodology highly desired
  • Ability to thrive in a fast-paced environment while managing multiple projects with competing priorities successfully
  • Highly organized with a focus on detail-orientation and possesses excellent communication skills
  • Superior analytical and problem-solving skills

EnableComp, LLC
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