Revenue Specialist, Physician Billing

Our Mission We partner with healthcare providers to maximize reimbursement from complex claims payers by having the best people, processes, products and performance.

Our Vision

We enable healthcare providers to do what they do best.

Position Summary

The Revenue Specialist, Physician Billing acts as the liaison between key client contacts and insurance companies to ensure prompt reimbursement resolution.  This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.

Responsibilities

• Analyze and evaluate worker's compensation claim payments using EnableComp's proprietary software, systems and tools.
• Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state worker's compensation fee schedule and/or PPO contract for professional/physician groups.
• Research, request and acquire all necessary medical records, implant manufacturer's invoices and any other supporting documentation necessary and then submit physician's claims to insurance companies to ensure prompt and correct claims reimbursement.
• Conduct timely and thorough telephone follow-up with worker's compensation insurance companies to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.
• Prepare correct workers' compensation billing packets and/or underpayment review letters using EnableComp tools; ensure proper submission including supporting documentation to insurance companies.
• Other duties as required.

Qualifications and Skills

• High School Diploma or GED required. Associates or Bachelor's Degree preferred.
• 1-2+ years' experience in healthcare field working in billing or collections, Physician / Professional billing desired.
• 1+ years' client facing/customer services experience.
• 1+ years' experience with workers compensation billing and collections a preferred.
• Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements.
• Equivalent combination of education and experience will be considered.
• 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.
• Timely and regular attendance.
• Proven ability to meet and/or exceed productivity targets and goals.
• Maintains a professional image and provides excellent customer service.
• 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.