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We partner with over 1,000 healthcare providers to maximize their complex claims reimbursements.
Resolution Analyst – Denials
Location
Tennessee
Posted
48 days ago
Salary
0
Seniority
Senior
Job Description
Resolution Analyst – Denials
EnableComp
• Acts as the liaison between key client contacts and our denials and underpayment appeal process to the appropriate payer. • Responsible for facilitating payment review recovery efforts for denied and underpaid accounts for assigned clients, thereby increasing the departments revenue. • Responsible for handling patient health information (PHI) and maintaining extreme privacy and security.
Job Requirements
- High School Diploma or GED required. Associates or Bachelor’s Degree preferred.
- 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.
- 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).
- 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, and Federal and State requirements.
- Familiarity with HMO, PPO, IPA, and capitation terms and how these payors process claims.
- Intermediate understanding of EOB, hospital billing form requirements (UB04), and familiarity with the HCFA 1500 forms.
- Demonstrate strong ability to review client/payer contracts to identify complex underpayments.
- Regular and predictable attendance.
- 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.
Benefits
- EnableComp is an Equal Opportunity Employer M/F/D/V.
- A commitment to creating and maintaining a workforce environment that is free from discrimination or harassment.
- A culture centered around fostering the professional growth and development of employees.
- A commitment to living up to core values each day.
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