[Remote] Provider Enrollment Specialist at EnableComp

United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

High School Diploma or GED required; Associates or Bachelor’s Degree preferred
1+ 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
Thorough understanding of the enrollment requirements and documents needed for the accurate completion of applications
Strong computer proficiency and understanding of basic office applications (MS Office: Word, Excel, Outlook)
Regular and predictable attendance

Responsibilities

Collect, verify, and submit information necessary for the enrollment of hospitals/physicians with Out-of-State Medicaid payers
Develop and maintain ongoing policy and procedures specific to each state for new hospital/physician enrollments
Maintain working knowledge of hospital/physician Out-of-State Medicaid enrollment requirements and regulations
Ensure appropriate education and communication is shared with internal team members, including the Vice President and Senior Vice President of Operations
Submits re-enrollment applications in a timely manner to ensure hospitals/physicians are up to date with their enrollment status
Establish, maintain, and constantly review the accuracy of Out-of-State Medicaid requirements to ensure compliance with government rules and regulations
Manage work queue to ensure all timely submissions/deadlines of all payor-specific forms and documents to the various health plans including license updates, deficiency notifications, approval letters, etc
All maintenance of the provider file and communication of provider changes, corrections, and terminations documented in the database

Skills

EnableComp

Maximizes revenue from workers' compensation claims

About EnableComp

EnableComp focuses on helping healthcare providers maximize revenue from complex workers' compensation claims, which are often difficult to manage. The company simplifies this process by using a combination of clinical expertise, data analytics, managed care, and proprietary technology. Their main product, Enforcer, is a software that streamlines the management of these claims, allowing healthcare providers to concentrate on their core operations while EnableComp handles the billing and collections. Unlike competitors, EnableComp operates on an outsourcing model, taking over the claims management process for healthcare providers, which saves them time and resources. The goal of EnableComp is to ensure that their clients receive the highest possible reimbursement from workers' compensation claims.

Franklin, TexasHeadquarters

2000Year Founded

$5.3MTotal Funding

MERGERCompany Stage

Data & Analytics, Consulting, HealthcareIndustries

201-500Employees

Benefits

Flexible Work Hours

Professional Development Budget

Unlimited Paid Time Off

Risks

Emerging RCM technology companies may erode EnableComp's market share with competitive solutions.

Labor shortages in healthcare could impact EnableComp's service delivery and client satisfaction.

Frank Forte's appointment as CEO may lead to strategic shifts, risking client retention.

Differentiation

EnableComp specializes in complex workers' compensation claims management for healthcare providers.

Their proprietary software, Enforcer, enhances efficiency in claims processing and collections.

EnableComp's outsourcing model allows healthcare providers to focus on core operations.

Upsides

Increased AI adoption enhances EnableComp's claims processing and denial management efficiency.

RPA integration in billing offers automation opportunities, improving accuracy for EnableComp.

Healthcare providers' outsourcing trend aligns with EnableComp's business model, boosting partnerships.

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