[Remote] Reimbursement Analyst at EnableComp

United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor’s degree required
Minimum of 3 years of experience in healthcare reimbursement analysis
Proficiency in medical coding, billing, claims processing, and IT systems
Expertise in MS Office, especially Word, Excel, and Outlook
Strong understanding of hospital and professional coding and reimbursement methodologies is mandatory
Experience in working with IT and system development is a plus

Responsibilities

Collaborate with individuals from every facet of the organization, identify and analyze jurisdictional fee schedule guidelines, draft effective FS SME Logic documents, summarize said rules for end-user comprehension, and coordinate User Acceptance Testing (UAT) in the development (DEV) environment to ensure reimbursement requirements are executed accurately prior to deployment to production (PROD)
Identify, investigate, and resolve reimbursement-related issues for jurisdiction-specific and hospital (e.g., inpatient, outpatient) and professional fee schedules
Partner directly with IT development to define and translate business requirements for timely and precise fee schedule coding, testing, troubleshooting, and deployment
Track and access ongoing updates to published and upcoming new fee schedules, conducting periodic reviews to ensure rule accuracy and compliance
Monitor system reminders, alerts, error logs, data integrity reports, and anomalies within PROD data to maintain operational reliability
Update fee schedule state rules and load associated data tables promptly and accurately
Support communication, training, and documentation efforts related to fee schedule updates
Exercise independent judgment and discretion in executing responsibilities outlined above
Perform additional duties as assigned

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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