EnableComp, LLC
  • Revenue Services
  • 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 Denials Specialist acts as the liaison between key client contacts and our denials appeal process to the appropriate payer. The Specialist is responsible for the thorough analysis, research and ultimate resolution of claim denials. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.

Key Responsibilities

  • Analyze and evaluate administrative, clinical and technical denials and other assigned claims using EnableComp's proprietary software, systems and tools. Use payment documentation provided by payers and medical provider contact information to determine the correct reimbursement.
  • Research, request and acquire all pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to the appropriate payer to ensure prompt correct claims reimbursement.
  • Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.
  • Assist in identifying root cause, patterns and trends relative to assigned clients to prevent denials.
  • Other duties as required

Requirements and Qualifications

  • High School Diploma or GED required. Associates or Bachelor's Degree preferred.
  • 1-2+ years' experience in healthcare field working in billing or collections.
  • 1+ years' client-facing/customer services experience.
  • 1+ years' experience with commercial billing, collections, and denial appeals required. Other complex claims experience a plus.
  • Advanced level understanding of insurance payer/provider claims processing and subsequent data requirements.
  • 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

  • Practices and adheres to EnableComp's Core Values, Vision and Mission.
  • Regular and predictable attendance.
  • Proven ability to meet and/or exceed productivity targets and goals.
  • Maintains stable performance under pressure or opposition. Handles stress in ways to maintain relationships with all stakeholders.
  • Must be a self-starter and able to work independently without direct supervision.
  • Proven written and verbal communication skills.
  • Strong analytical and problem-solving skills.
  • Proven experience working with external clients; strong customer service skills and business acumen.
  • Ability to prioritize and manage multiple competing priorities and projects concurrently.
  • Must be able to remain in stationary position 50% of the time.
  • Occasionally moves about inside the office to access office equipment, etc.
  • Constantly operates a computer and other office equipment such as a copy/scan/print machine, phone and computer.

EnableComp, LLC
  • Apply Now

  • * Fields Are Required

    What is your full name?

    How can we contact you?

  • Sign Up For Job Alerts!

  • Follow Jobs:
  • Follow Our Jobs On Facebook
  • Share This Page