EnableComp
We partner with over 1,000 healthcare providers to maximize their complex claims reimbursements.
Revenue Specialist, Third Party Claims
Location
United States
Posted
6 days ago
Salary
Not specified
No structured requirement data.
Job Description
The Revenue Specialist, Third-Party Claims investigates and analyzes Motor Vehicle Accident accounts in order to properly identify and coordinate insurance benefits and resolve outstanding balances for our clients. This position acts as the liaison between EnableComp clients, patient attorneys, and insurance companies. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.
Conduct online medical research of Motor Vehicle Accident claim payments using EnableComp’s proprietary software, systems, and tools, as well as other online medical websites.
Research, request, acquire, and review medical records, provider notes, explanation of benefits and any other supporting documentation necessary for knowledge of account information.
Utilize information to manage claim life cycle and accurately communicate with external patient counsel and insurance providers.
Conduct timely and thorough follow-up with payers to update claim system with accurate information and ensure supporting documentation has been received facilitating prompt reimbursement.
Make key decisions to ensure claim resolution.
Prepare correct MVA billing packet using EnableComp systems tools and submit with all necessary supporting documentation to insurance companies and patient attorney, with appropriate authorizations.
Communicate with patient attorney via various mediums in order to discuss claim status and probability of timely resolution.
Other duties as required.
Job Requirements
- High School Diploma or GED required. Associate or bachelor’s Degree preferred.
- 2+ years’ experience in healthcare field working in billing or collections.
- 2+ years’ client facing/customer services experience.
- 1+ years’ experience with MVA claim resolution preferred. Other complex claims experience a plus.
- Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
- Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements in relation to motor vehicle claims.
- Intermediate level understanding of MVA legal requirements.
- An equivalent combination of education and experience will be considered.
- Regular and predictable attendance.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions.
- Practices and adheres to EnableComp’s Core Values, Vision and Mission.
- Proven ability to meet and/or exceed productivity targets and goals.
- Maintains a professional image and provides excellent customer service.
- Maintains stable performance under pressure or opposition. Handles stress in ways to maintain relationships with all stakeholders.
- Must be a self-starter and able to work independently without direct supervision.
- Proven written and verbal communication skills.
- Strong analytical and problem-solving skills.
- Proven experience working with external clients; strong customer service skills and business acumen.
- Attend weekly team meetings to discuss updates/changes such as new hospital procedures or current client issues.
- Communicate any issues through the manager including, but not limited to, systems errors, questions for other departments, HIPAA questions.
- Constantly operates a computer and phone.
Benefits
- EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status.
- We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.
- EnableComp recruits, develops and retains the industry's top talent.
- As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people.
- We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here.
