Remote Denials Resolution Analyst

Summary

Join EnableComp as a Denials Resolution Analyst and act as a liaison between key client contacts and our denials and underpayment appeal process to maximize reimbursement from complex claims payers.

Requirements

• 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
• 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
• Regular and predictable attendance

Responsibilities

• Review, evaluate, appeal, and follow up on outstanding, denied, underpaid, 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
• Efficiently review hospital contracts to identify and collect cash payments from insurance companies, ensuring prompt payments of denied and underpaid claims
• Research, request, and acquire all pertinent medical records and supporting documentation to create and submit complex underpayment appeals to the appropriate payer, ensuring accurate and timely claim reimbursement
• Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate resolution of outstanding receivables