Denials Revenue Specialist: Accelerate Reimbursements

Enablecomp; North Carolina; Remote; USD 60,000 - 75,000; Full time

Job summary

EnableComp in North Carolina is seeking a Revenue Specialist, Denials, to act as the liaison between client contacts and our denials appeal workflow. You will audit denials, collect medical records, and submit claims to payers to ensure prompt, accurate reimbursement while safeguarding PHI.

The role requires 5+ years in healthcare billing/collections, 1+ year of client-facing experience, and solid knowledge of ICD, HCPCS/CPT, and the revenue cycle.

Qualifications

• 5+ years’ experience in healthcare field working in billing or collections.
• 1+ years’ client facing/customer services experience.
• Intermediate understanding of insurance payer/provider claims processing and data requirements.
• Familiarity with HMO, PPO, IPA, and capitation terms and how payors process claims.

Responsibilities

• Review and evaluate Denied and other assigned claims using EnableComp’s proprietary software and tools.
• Research, request and acquire all pertinent medical records and supporting documentation and submit with hospital claims to the payer.
• Conduct timely and thorough telephone follow-up with payers to ensure timely reimbursement.
• Other duties as required.

Skills

Healthcare billing

Client facing

Data analysis

Communication skills

Revenue cycle knowledge

Denials handling

MS Office

Education

High School Diploma or GED

Associates or Bachelor's Degree preferred

Tools

MS Office

Job description

EnableComp in North Carolina is seeking a Revenue Specialist, Denials, to act as the liaison between client contacts and our denials appeal workflow. You will audit denials, collect medical records, and submit claims to payers to ensure prompt, accurate reimbursement while safeguarding PHI.

The role requires 5+ years in healthcare billing/collections, 1+ year of client-facing experience, and solid knowledge of ICD, HCPCS/CPT, and the revenue cycle.