EnableComp
Healthcare
ResolutionAnalyst,Denials
Neural analysis suggests this role is
optimal for Mid candidates.
“Resolution Analyst, Denials at EnableComp. Skills: Revenue Cycle Management, Claims Resolution, Payer Relations. Review claims. evaluate claims”
What You'll Achieve.
increasing the departments revenue; accelerated cash; higher and more accurate yield; clean AR management; reduced denials; data-rich performance management; meeting and/or exceed productivity targets and goals
Industry & Context.
Strong analytical and problem-solving skills
handling patient health information (PHI), maintaining extreme privacy and security, Must be able to remain in stationary position 50% of the time, Occasionally moves about inside the office to access office equipment, Constantly operates a computer and other office equipment
What They're Looking For.
Must Have
High School Diploma or GED required, 5+ years’ experience in healthcare field working in billing or collections, 1+ years’ client facing/customer services experience, Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements, computer proficiency, understand how to use basic office applications, MS Office (Word, Excel, and Outlook), Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology, Strong understanding of the revenue cycle process, Full understanding of hospital reimbursement, Intermediate knowledge of Managed Care contracts, Contract Language, Federal and State requirements, Familiarity with HMO, PPO, IPA, and capitation terms, Intermediate understanding of EOB, hospital billing form requirements (UB04), familiarity with the HCFA 1500 forms, Demonstrate ability to review client/payer contracts to identify complex underpayments, Regular and predictable attendance
Nice to Have
Associates or Bachelor’s Degree preferred
What You'll Do.
Use payment documentation
Use medical provider contract information
Review hospital contracts
collect cash payments
Research medical records
request supporting documentation
submit underpayment appeals
Conduct telephone follow-up with payers
facilitate resolution of receivables
improves customer satisfaction
How You'll Work.
Team & Collaboration
acts as the liaison between key client contacts and our denials and underpayment appeal process to the appropriate payer
Communication Scope
Proven written and verbal communication skills
Process & Methodology
Ability to prioritize and manage multiple competing priorities and projects concurrently
Full Job Description
## Description EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified 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 provides 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 supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years. Position Summary The Resolution Analyst acts as the liaison between key client contacts and our denials and underpayment appeal process to the appropriate payer. The Resolution Analyst is responsible for facilitating payment review recovery efforts for denied and underpaid accounts for assigned clients, thereby increasing the departments revenue. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information. ## Key Responsibilities Review, evaluate, appeal, and follow up on outstanding, denied, underpaid, and other assigned claims using EnableComp’s proprietary software, systems a
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