EnableComp

• Collaborate directly with the IT & Development teams to design and integrate advanced AI security tooling at the application level. • Take a leading role in enhancing the security capabilities of our flagship in-house application, "Enforcer," by leveraging cutting-edge AI technologies. • Partner with our Development teams to establish a secure AI development lifecycle. • Assist in the evaluation, selection, and secure configuration of AI/ML tools, libraries, and platforms to empower our developers while maintaining a robust security posture. • Act as the central point of contact for vetting and suggesting secure AI solutions for business units across the entire organization. • Develop and maintain a curated portfolio of approved AI tools and services that align with our security standards and business objectives. • Stay at the forefront of the rapidly evolving AI landscape, including new technologies, emerging threats, and changing regulatory requirements (e.g., GDPR, CCPA as they relate to AI). • Provide regular updates and strategic recommendations to leadership on AI-related security matters. • Manage and optimize our TPRM platform. • Leverage the platform to establish and streamline a comprehensive AI vendor assessment process, creating clear requirements for onboarding new AI partners and solutions. • Contribute to the daily operations and strategic initiatives of the broader Information Security team. • Assist in incident response, threat modeling, and security architecture reviews as needed.

• quantitative analysis and predictive modeling of healthcare data to provide management with statistical findings and conclusions • develop, collect and analyze metrics and data to formulate fact-based decisions • proactively implement process improvements through analysis of claim and operational data

• Architect and build a scalable Agentic AI framework specifically for RCM workflows. • Design autonomous agents capable of handling complex revenue cycle tasks (denial management, contract analysis, eligibility verification). • Establish orchestration patterns for agent collaboration across different RCM business functions. • Implement robust guardrails and validation mechanisms for AI decision-making in financial contexts. • Build reusable components that accelerate agent development for new RCM use cases. • Create specialized tools for training and fine-tuning AI models on healthcare financial data. • Lead distributed engineering teams across onshore and offshore location.

• Define and execute the strategic vision, operating model, and growth roadmap for the WC and MVA service lines, aligned with business objectives. • Provide executive oversight of operational performance, ensuring revenue targets, client outcomes, and efficiency goals are consistently achieved. • Establish and monitor key performance indicators, ensuring visibility into performance drivers and accountability across all levels of the organization. • Lead long-term capacity planning, organizational design, and resource allocation to support scalability and profitable growth.

• Provide leadership and supervision to the Revenue Recovery products • Acts as a subject matter expert in EnableComp Revenue Integrity related products • Define and establish departmental goals, financial targets, and key performance indicators that align with company objectives • Oversee the development of quality and productivity metrics and benchmarks for Revenue Recovery functions • Ensure the processes and inventory are in place to hit monthly, quarterly, and annual revenue expectations • Responsible for hiring, staff training, and oversight • Coordinate resources throughout the organization to address action plans for assigned clients and projects • Collaborate cross-functionally with other senior leaders to guide corporate planning, resource allocation, and strategic partnerships • Responsible for setting daily priorities to ensure impactful work is prioritized • Measures and monitors key performance metrics and delivers concise performance reporting to stakeholders • Researches and analyzes operational processes and systems to identify process improvement opportunities • Participate in high-level client relationships and ensure client satisfaction • Develops a high-performing team through effective leadership, coaching, and accountability • Maintain a strong knowledge of DRG coding, clinical documentation, and reimbursement methodologies

• Provide executive leadership and strategic oversight across service lines for Workers’ Compensation (WC) & Motor Vehicle Accidents (MVA). • Define the vision, strategy, and operating model for WC and MVA. • Ensure sustained revenue growth and operational excellence. • Identify opportunities, mitigate risk, and drive innovation. • Establish frameworks and performance expectations for effective execution by the leadership team.

• Independently own operational alignment for assigned client accounts • Develop a deep working knowledge of client contracts, SLAs, service-line scope, workflows, and operational dependencies • Translate operational performance data into meaningful narratives that clearly articulate drivers, risks, and opportunities • Proactively identify trends, risks, and misalignment across the client lifecycle and recommend corrective actions • Partner with clients to align operational expectations with internal capabilities and constraints • Monitor operational performance indicators and inventory health to identify emerging issues or deviations • Lead structured root cause analysis efforts in partnership with Revenue Services and other internal teams • Develop clear, outcome-oriented action plans with defined ownership, sequencing, and follow-up • Track action plan progress and validate effectiveness over time • Exercise sound judgment in determining when and how to escalate issues, providing clear context, analysis, and recommended paths forward • Own preparation and facilitation of monthly operational reviews and recurring client touchpoints • Develop agendas, reporting narratives, and discussion materials tailored to client priorities • Lead client discussions with confidence, professionalism, and consultative presence • Document meeting outcomes, decisions, and action items, ensuring clear follow-through • Serve as a consistent and reliable operational presence for assigned client accounts • Partner closely with Revenue Services leadership and operational teams to understand performance drivers and constraints • Coordinate with Client Success, Implementation, Product, and Technology teams to support alignment across the client lifecycle • Lead internal account reviews and ensure internal stakeholders are aligned on priorities, risks, and commitments • Advocate for client needs while balancing enterprise standards and scalability • Ensure accurate and timely documentation of client interactions, escalations, and decisions in CRM and internal systems • Apply Client Alignment methodologies and standards consistently across assigned accounts • Identify recurring themes, systemic issues, or improvement opportunities across the client portfolio • Contribute to process improvement initiatives, workflow refinement, and documentation updates • Support onboarding and knowledge transfer for new team members as needed • Other duties as assigned

• Lead, develop, and mentor Zero Balance team members, fostering a high-performance, accountable culture. • Oversee the full employee lifecycle, including hiring, onboarding, training, performance management, and succession planning. • Establish clear expectations, performance metrics, and accountability across the team. • Directly coach and develop Supervisors, strengthening leadership capability, decision-making, and accountability within the team. • Provide leadership across multiple layers of the department, ensuring alignment, consistency, and accountability across both direct and indirect reports. • Hold Supervisors accountable for team performance, including productivity, quality, and adherence to workflows and service level expectations. • Provide ongoing coaching and leadership to drive quality, productivity, and professional development. • Define and execute Zero Balance recovery strategies across large and complex claim inventories. • Drive operational efficiency, scalability, and continuous improvement across workflows and processes. • Monitor team performance, identify trends, and implement action plans to improve outcomes and recovery rates. • Ensure adherence to workflows, compliance standards, and quality expectations through oversight and governance. • Serve as a senior subject matter expert in hospital reimbursement, payer behavior, and zero balance recovery strategies. • Oversee complex claim analysis, ensuring accurate evaluation of payments against contractual reimbursement. • Guide team application of coding knowledge (CPT, ICD-10, modifiers) to maximize recovery success. • Provide direction on escalated claims, payer issues, and recovery opportunities. • Act as a primary point of contact for client relationships, ensuring satisfaction, transparency, and trust. • Lead client communications related to performance, escalations, process improvements, and strategic initiatives. • Partner with internal stakeholders to align on client needs, expectations, and deliverables. • Facilitate discussions to address client concerns and drive resolution of operational challenges. • Partner with Technology, Data Analytics, Product, and Operations teams to resolve claim, payment, and system issues. • Support development and enhancement of tools, reporting, and processes to improve outcomes. • Collaborate on enterprise initiatives and special projects to advance organizational goals. • Establish and oversee quality control programs to ensure accuracy, compliance, and due diligence. • Analyze performance data and reporting to drive informed decision-making and continuous improvement. • Ensure timely and accurate submission of bill packets, appeals, and follow-up activities. • Drive measurable financial results through effective recovery strategies and team execution. • Identify opportunities to increase revenue recovery and improve client outcomes. • Align team priorities with organizational goals and financial targets. • Monitor and evaluate individual and team performance, ensuring alignment to productivity, quality, and behavioral expectations; proactively address performance gaps through clear accountability, coaching, and structured follow-up. • Provide timely, direct, and constructive feedback, including leading difficult conversations with professionalism and respect; build trust-based relationships that foster accountability, engagement, and continuous improvement. • Make employment decisions, including corrective action and termination, in alignment with company policy and business needs.

• Lead and manage Client Support Specialists/Representatives setting clear expectations for performance, accountability, and professional development • Own team-level performance across inventory reconciliation, prebill work queue resolution, and documentation workflows, ensuring all functions operate within established KPI standards • Monitor and analyze team performance metrics, identify trends and gaps, and implement corrective action plans to drive continuous improvement • Manage escalations from the team related to non-routine reconciliation issues, workflow barriers, complex account situations, and personnel matters • Identify and escalate recurrent process gaps that contribute to claims appearing on reconciliations to the Director, Client Support, supporting upstream resolution by Revenue Services • Identify and report systemic client system issues and workflow barriers to the Director, Client Support for resolution or cross-functional escalation • Coordinate with Client Delivery leadership to maintain operational alignment on client-impacting items, ensuring the Client Support team’s work product supports downstream delivery needs • Ensure accurate and consistent E360 documentation standards are maintained across the team through Supervisor oversight and periodic audits • Drive process improvement initiatives within the Client Support team, refining workflows, updating standard operating procedures (SOPs), and implementing best practices • Ensure client support processes are documented appropriately and that all relevant parties are trained and informed of process updates • Lead workforce planning efforts including workload distribution, capacity assessment, and staffing recommendations in coordination with the Director, Client Support • Responsible for hiring, onboarding, and training of Client Support team members • Conduct annual goal planning, performance reviews, and ongoing development plans for direct reports • Develop individual contributors through coaching, feedback, and structured development opportunities

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 Revenue Specialist, Medicaid ensures proper submission and adjudication of all claims submitted to Medicaid carriers while working within the deadlines and protocols of the assignments. 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 - Verify patient eligibility when needed. - Analyze and evaluate Medicaid claim payments using the company’s systems and tools. Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state fee schedule. - Research, request and acquire all pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to ensure prompt correct claims reimbursement. - Review technical billing (UB 04) components provided by Client Hospital for accuracy. Make necessary changes as required in accordance with billing laws. - Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement. - Prepare correct Medicaid initial bill packet using EnableComp systems’ tools and submit with all necessary supporting documentation to insurance companies - Analyze all assigned account delinquencies and account activity to ensure timely and accurate payments from appropriate payers. - Work with insurers and outside entities through various avenues to verify/request authorizations and assist in concurrent review activities to obtain authorization as needed. - File and handle confidential documentation and patient health information (PHI); adhere and follow all HIPAA mandated guidelines. - Manage both inbound and outbound calls efficiently and effectively. - Assist in efficiently moving work through the department, working as part of a team. - Appeal claim denials and/or underpayments as necessary. - Other duties as required Requirements and Qualifications - High School Diploma or GED required. Associates 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 UB-04 billing and collections required. CMS-1500 billing and other complex claims experience a plus. - Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements. - Intermediate level understanding of Medicaid payers preferred. - Equivalent combination of education and experience will be considered. - Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook). - Regular and predictable attendance. - 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. Special Considerations and Prerequisites - Practices and adheres to EnableComp’s Core Values, Vision and Mission. - Proven ability to meet and/or exceed productivity targets and goals. - 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. - Ability to prioritize and manage multiple competing priorities and projects concurrently. - Must be able to remain in stationary position 50% of the time. - Occasionally moves about inside the office to access office equipment, etc. - Constantly operates a computer and other office equipment such as a copy/scan/print machine, phone and computer. 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. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies. If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you. Don’t just take our word for it! Hear what our people are saying: “I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other.” – Revenue Specialist “I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun.” – Supervisor, Operations