Revenue Specialist, WC (REMOTE)

Davita Inc.; Franklin (TN); Remote; USD 40,000 - 55,000; Full time

Job summary

A leading company in the healthcare sector is seeking a Revenue Specialist in Franklin, Tennessee. This role involves analyzing workers' compensation claims, ensuring accurate reimbursements, and maintaining client relationships. Ideal candidates will have a background in healthcare billing, strong communication skills, and a commitment to compliance and quality service.

Qualifications

• 1-2+ years' experience in healthcare billing or collections required.
• Experience with workers' compensation billing preferred.
• Intermediate understanding of insurance claims processing required.

Responsibilities

• Analyze and evaluate worker's compensation claim payments.
• Research and acquire relevant medical records and supporting documentation.
• Prepare accurate billing packets and follow-up with payers.

Skills

Analytical skills

Communication

Problem-solving

Customer service

Education

High School Diploma or GED

Associate's or Bachelor's Degree

Tools

MS Office

Job description

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp offers solutions across the revenue lifecycle for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims, as well as denials for all payer classes. By partnering with clients to enhance the reimbursement process, EnableComp reduces the payment burden on patients and providers while enabling faster cash flow, higher and more accurate yields, clean AR management, fewer denials, and data-rich performance management. EnableComp has received multiple recognitions, including the Top Workplaces award and being named Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024, and consistently ranks among the top one percent of companies on the Inc. 5000 list of fastest-growing private companies in the U.S.

Position Summary

The Revenue Specialist serves as the liaison between key client contacts and insurance companies. This role involves handling patient health information (PHI) with utmost confidentiality and security, ensuring compliance with privacy standards.

Key Responsibilities

• Analyze and evaluate worker's compensation claim payments using EnableComp's proprietary software, systems, and tools. Review payment documentation from payers to verify reimbursement in accordance with applicable state worker's compensation fee schedules and/or PPO contracts.
• Research, request, and acquire relevant medical records, implant manufacturer's invoices, and other supporting documentation; submit these with hospital claims to insurance companies to ensure prompt and accurate reimbursement.
• Conduct timely follow-up calls with payers to confirm receipt of claims with supporting documentation and facilitate prompt reimbursement.
• Prepare accurate Workers' Compensation initial bill packets or appeal letters using EnableComp's systems and submit them with all necessary documentation to insurance companies.
• Perform other duties as assigned.

Requirements and Qualifications

• High School Diploma or GED required; Associate's or Bachelor's Degree preferred.
• 1-2+ years' experience in healthcare billing or collections.
• At least 1 year of client-facing/customer service experience.
• Experience with workers' compensation billing and collections is preferred.
• Intermediate understanding of insurance claims processing and data requirements.
• Proficiency in MS Office applications (Word, Excel, Outlook).
• Equivalent education and experience considered.
• Ability to perform essential duties satisfactorily and maintain regular attendance.

Special Considerations and Prerequisites

• Adherence to EnableComp's Core Values, Vision, and Mission.
• Proven ability to meet productivity goals.
• Ability to work under pressure and handle stress professionally.
• Self-motivated with the ability to work independently.
• Strong communication, analytical, and problem-solving skills.
• Experience working with external clients and strong customer service skills.
• Ability to prioritize multiple tasks.
• Must be able to remain stationary for 50% of the time and operate office equipment.

EnableComp is an Equal Opportunity Employer. All applicants will be considered without regard to race, color, religion, national origin, sexual orientation, or other protected statuses. We are committed to a discrimination-free workplace.

We invest in our employees' growth and development, believing that our success depends on our team. If you value a company that supports your professional growth and aligns with your values, EnableComp is the right place for you.