Remote Underpayment Specialist, Denials

Summary

Join EnableComp as an Underpayment Analyst and act as a liaison between key client contacts and our denials and underpayment appeal process to the appropriate payer. This role is responsible for facilitating payment review recovery efforts for denied and underpaid accounts for assigned clients, thereby increasing the departments revenue.

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

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

Benefits

EnableComp is an Equal Opportunity Employer M/F/D/V