Medicaid Claims Revenue Specialist

EnableComp; Franklin (TN); On-site; USD 40,000 - 60,000; Full time

Job summary

EnableComp is seeking a Revenue Specialist to ensure Medicaid claims are submitted and adjudicated accurately. You will verify eligibility, analyze payments, and gather records to support timely reimbursements while protecting PHI under HIPAA guidelines.

The role emphasizes collaboration with payers, internal teams, and external clients, with a focus on efficient processing and compliant handling of sensitive health information.

Qualifications

• 1–2+ years in healthcare billing or collections.
• 1+ years' client-facing/customer service experience.
• 1+ years' UB-04 billing and collections experience required.
• CMS-1500 billing experience is a plus.
• Proficient in MS Office (Word, Excel, Outlook).

Responsibilities

• Verify patient eligibility when needed.
• Analyze Medicaid claim payments using company systems.
• Research and submit supporting documentation with hospital claims.
• Review UB-04 components for accuracy and changes as required by billing laws.
• Follow up with payers to ensure timely reimbursement.
• Prepare Medicaid initial bill packets with required documentation.
• Analyze delinquencies and ensure timely payments.
• Coordinate authorizations with insurers as needed.
• Handle PHI with HIPAA-compliant processes.
• Manage inbound/outbound calls and teamwork.
• Appeal denials and underpayments when required.
• Assist in workflow efficiency across the department.

Skills

UB-04 Billing

CMS-1500 Billing

Client Facing

MS Office

Healthcare Billing

Education

High School Diploma or GED

Associates or Bachelor's Degree preferred

Job description

EnableComp is seeking a Revenue Specialist to ensure Medicaid claims are submitted and adjudicated accurately. You will verify eligibility, analyze payments, and gather records to support timely reimbursements while protecting PHI under HIPAA guidelines.

The role emphasizes collaboration with payers, internal teams, and external clients, with a focus on efficient processing and compliant handling of sensitive health information.