EnableComp, LLC
  • CAID
  • 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 Follow-Up Specialist resolves health insurance claims on behalf of hospital or physician clients. They ensure proper submission and adjudication of all claims submitted to third-party carriers and also work within the deadlines and protocols of the hospitals served. The individual in this role is responsible for providing a timely response to all billing releases and inquiries in accordance with the policies and procedures of the hospital revenue cycle they are assigned within. This role will be responsible for knowledge in billing regarding technical billing and basics on physician billing. They will submit changes that are permitted by law, hospital SOP's and stay current on changing billing practices that will occur annually.

Key Responsibilities

  • Review technical billing (UB04) and professional billing (1500) components provided by Client Hospital for accuracy. Make/request necessary changes as required in accordance with billing laws. Maintains account integrity by documenting account activities to ensure audit trail.
  • Verify eligibility/coverage with health insurance carriers.
  • Follow established protocol and processes to contact appropriate parties to retrieve proper payment by assessing the situation for i.e. Authorization, additional allowance.
  • Analyze all assigned account delinquencies and account activity to ensure timely and accurate payments from appropriate payers.
  • Communicate with health insurers regarding pending claims and any unpaid balances.
  • Appeal claim denials and/or underpayments as necessary.
  • Stay up-to-date on ever-changing insurance industry protocol.
  • Additional responsibilities as assigned.

Requirements and Qualifications

  • High School Graduate with a minimum of 3 years experience in healthcare revenue processes and/or 1-2 years college (or the equivalent combination of education and experience).
  • Hospital/Physician medical billing experience, health insurance knowledge, strong experience with UB04 and HCFA 1500
  • Must have strong computer proficiency and understanding of how to use MS Office Suite (Word, Excel, and Outlook) and Windows applications.
  • Strong analytical skills and high attention to detail. Must be self-driven and demonstrate relentless initiative toward researching and ultimately resolving claims.
  • Well-developed communication skills - oral, written, listening. Effective interpersonal communication.

Special Considerations and Prerequisites

  • Practices and adheres to EnableComp's Core Values, Vision and Mission.
  • Poised, polished professional that functions with a high level of integrity, confidentiality and excellence.
  • Handles high pressure situations appropriately and exercises extreme judgement when handling confidential matters.
  • Enjoys working in a fast-paced environment.
  • Demonstrated propensity to take initiative.
  • Strong follow through and customer service orientation.
  • Highly detail-oriented and must be able to manage conflicting priorities, while being extremely adaptable and flexible.
  • Excellent interpersonal skills in addition to superior written and verbal communication skills.
  • Regular and predictable attendance.
  • General office environment must be able to lift 20 pounds.

EnableComp, LLC
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