EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCMTM 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.
Requirements
- Responsible for the daily supervision of assigned Revenue Services teams.
- Serves as the primary escalation point, to directly or through staff, work with clients to resolve roadblocks that may hinder the claims resolution process and provides direction to Account Managers and Revenue Specialists to resolve existing claims/ client issues.
- Partners with Managers to disseminate priority of daily tasks to assigned team.
- Prepare performances evaluations and account reviews and plays a role in delivering both documents in conjunction with the Department Leader.
- Analyze and evaluate claim payments using EnableComp’s proprietary software, systems and tools.
- Research, request and acquire all pertinent medical records, implant manufacturer’s invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement.
- Manage internal coordination, communication, and messaging for external client requests and reported issues.
- Create, review, and maintain external-facing client reports.
- Facilitate internal and external meetings to discuss process improvements, resolve client issues, and/or resolve internal issues.
- Respond and communicate with external clients regarding topics such as: remote system access, document requests, payment research requests, coordination of end-user training, and others.
- Conduct timely and thorough telephone follow-up with insurance companies to ensure proper reimbursement.
- Prepare correct initial bill packet or appeal letter using EnableComp systems tools.
- Works with Data Analytics team to research issues with claim and payment imports, etc.
- Trains and mentors staff as needed including new hires, especially in regards to ongoing training needs that may result from the SOP for goal escalation.
- Works with Data Quality team to research issues with calculations and other projects.
- Works with Document Management team to remove roadblocks around document acquisition and other requisite items needed to collect accounts.
- Perform Quality Control tasks on behalf of management regarding account flow and due diligence.
- Usually works more difficult clients.
- Responsible for the full employee life cycle including hiring decisions, training, performance management, and corrective action.
- Handle patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.
- Support operational initiatives through team collaboration.
- Other duties as required.
Benefits
- Equal Opportunity Employer
- Flexible work environment
- Opportunities for professional growth and development
- Core values-based company culture
