EnableComp · 11 hours ago
Revenue Specialist, Denials
Franklin, TN
Full-time
Onsite
Senior Level
5+ years expEnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, and they are seeking a Revenue Specialist, Denials to act as a liaison between clients and the denials appeal process. The role involves auditing denied claims, acquiring necessary documentation, and ensuring prompt reimbursement from payers.
Health CareHospitalInformation Technology
Responsibilities
Review and evaluate Denied and other assigned claims using EnableComp’s proprietary software, systems and tools. Use payment documentation provided by payers and medical provider contract 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
Other duties as required
Qualification
Required
High School Diploma or GED required
5+ years' experience in healthcare field working in billing or collections
1+ years' client facing/customer services experience
Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements
Equivalent combination of education and experience will be considered
Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook)
Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology
Strong understanding of the revenue cycle process
Full understanding of hospital reimbursement, Intermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements
Familiarity with HMO, PPO, IPA, and capitation terms and how these payors process claims
Intermediate understanding of EOB, hospital billing form requirements (UB04), and familiarity with the HCFA 1500 forms
Demonstrate strong ability to review client/payer contracts to identify complex underpayments
Regular and predictable attendance
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
Practices and adheres to EnableComp's Core Values, Vision and Mission
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
Preferred
Associates or Bachelor's Degree preferred
Company
EnableComp
EnableComp is a provider of work comp reimbursement solutions.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Primus Capital Partners
2022-07-11Series Unknown
2017-08-07Series Unknown
Leadership Team
Christa Miller
Chief Financial Officer
Recent News
Bizjournals.com Feed (2025-11-12 15:43:17)
2026-01-13
Company data provided by crunchbase