Denials & Claims Optimization Specialist

EnableComp; Abbeyville (CO); On-site; USD 55,000 - 75,000; Full time

Job summary

EnableComp in Colorado seeks a Revenue Specialist, Denials to act as the liaison between client contacts and our denials appeal process, handling initial denial audits and ensuring proper resolution while maintaining PHI privacy.

You will review denied claims with EnableComp’s software, gather pertinent records, and submit to payers to secure prompt reimbursement. Strong billing experience and communication are essential.

Qualifications

• 5+ years’ experience in healthcare billing or collections.
• 1+ years’ client facing/customer services experience.
• Intermediate understanding of insurance payer/provider claims processing.
• Familiar with EOB, hospital billing form requirements (UB04).
• Strong computer proficiency with MS Office (Word, Excel, Outlook).
• Understanding of ICD, HCPCS/CPT coding and medical terminology.

Responsibilities

• Review denied and other assigned claims using EnableComp’s tools to determine correct reimbursement.
• Request and obtain medical records and supporting documentation for claims and submit with hospital claims.
• Conduct timely phone follow-up with payers to ensure prompt reimbursement.
• Perform other duties as required.

Skills

Analytical skills

Communication skills

Prioritization

Independent worker

Customer service

Education

High School Diploma or GED

Associates or Bachelor's degree preferred

Tools

MS Office

UB04/HCFA forms

Job description

EnableComp in Colorado seeks a Revenue Specialist, Denials to act as the liaison between client contacts and our denials appeal process, handling initial denial audits and ensuring proper resolution while maintaining PHI privacy.

You will review denied claims with EnableComp’s software, gather pertinent records, and submit to payers to secure prompt reimbursement. Strong billing experience and communication are essential.