We partner with healthcare providers to maximize reimbursement from complex claims payers by having the best people, processes, products and performance.
We enable healthcare providers to do what they do best.
The Revenue Specialist acts as the liaison between key client contacts and insurance companies. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.
Analyze and evaluate worker's compensation claim payments using EnableComp's proprietary software, systems and tools. Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state worker's compensation fee schedule and/or PPO contract.
Research, request and acquire all pertinent medical records, implant manufacturer's invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies 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.
Prepare correct Workers' Comp initial bill packet or appeal letter using EnableComp systems tools and submit with all necessary supporting documentation to insurance companies
Other duties as required
Requirements & 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 workers compensation billing and collections a preferred.
Intermediate 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 & Prerequisites
Practices and adheres to EnableComp's Core Values, Vision and Mission.
Timely and regular 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.