Billing Strategy Lead, Denials and Appeals
NateraSalary not specified
- Full Time
- Junior (1 to 2 years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare Revenue Cycle ManagementIndustries
Requirements
Candidates should possess a High School Diploma or GED, an Associate’s or Bachelor’s degree preferred, and a minimum of 5 years of experience in the healthcare field, specifically in billing or collections. They should have at least 1 year of client-facing or customer service experience, an intermediate understanding of insurance payer/provider claims processing, and proficiency in using basic office applications like MS Office. Furthermore, candidates must demonstrate an intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology, along with a full understanding of hospital reimbursement and intermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements. Familiarity with HMO, PPO, IPA, and capitation terms is also required.
Responsibilities
The Revenue Specialist, Denials will review and evaluate denied and other assigned claims using EnableComp’s proprietary software and tools, researching and requesting necessary medical records and documentation to ensure prompt and correct reimbursement. They will conduct timely telephone follow-up with payers to facilitate reimbursement and handle patient health information (PHI) with extreme privacy and security. Additionally, the role involves submitting claims with supporting documentation to the appropriate payer and performing other duties as required.
Skills
Revenue Cycle Management
Denials Management
Claims Auditing
Payer Communication
PHI Privacy & Security
Proprietary Software
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