Healthcare Revenue Specialist – Claims & Payer Liaison

EnableComp LLC; Franklin (TN); Remote; USD 42,000 - 62,000; Full time

Job summary

EnableComp LLC in the United States is seeking a Revenue Specialist to act as the liaison between key client contacts and insurance companies, handling patient health information (PHI) with extreme privacy and security. The role supports claims reimbursement and revenue cycle processes across physicians, hospitals, and health systems nationwide.

The Revenue Specialist will work with EnableComp’s 24+ years of expertise and its E360 RCM platform to improve financial sustainability, reduce denials,

Qualifications

• High School Diploma or GED required; Associate or Bachelor’s Degree preferred.
• 1-2+ years’ experience in healthcare field working in billing or collections.
• 1+ years’ client facing/customer services experience.
• 1+ years’ experience with workers compensation billing and collections a preferred.
• 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).
• Equivalent combination of education and experience will be considered.
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
• Regular and predictable attendance

Responsibilities

• Analyze and evaluate worker’s compensation claim payments using EnableComp’s proprietary software, systems and tools. Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state worker’s compensation fee schedule and/or PPO contract
• Research, request and acquire all pertinent medical records, implant manufacturer’s invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement
• Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement
• Prepare correct Workers’ Comp initial bill packet or appeal letter using EnableComp systems tools and submit with all necessary supporting documentation to insurance companies
• Other duties as required

Skills

Analytical skills

Customer service

Communication

MS Office

Education

High School Diploma or GED

Associate or Bachelor’s Degree

Tools

MS Office

Job description

EnableComp LLC in the United States is seeking a Revenue Specialist to act as the liaison between key client contacts and insurance companies, handling patient health information (PHI) with extreme privacy and security. The role supports claims reimbursement and revenue cycle processes across physicians, hospitals, and health systems nationwide.

The Revenue Specialist will work with EnableComp’s 24+ years of expertise and its E360 RCM platform to improve financial sustainability, reduce denials,