收入专员,第一方计费,MVA
Revenue Specialist, First Party Billing, MVA
EnableComp 为医疗机构提供专业收入周期管理解决方案,依托超过24年的行业领先经验以及其统一的 E360 RCM™ 智能自动化平台,提升全国医院、医疗系统和门诊手术中心(ASC)的财务可持续性。通过专有算法、1000万+ 处理索赔的迭代智能,以及专家级的人机协作集成,EnableComp 提供覆盖整个收入周期的解决方案,包括退伍军人事务、工伤赔偿、机动车事故以及非本州医疗补助索赔,以及所有付款人类型的拒付问题。通过与客户合作加速报销流程,EnableComp 将支付负担从患者和医疗机构中移除,同时实现加速现金流、提高并更准确的收益、干净的应收账款管理、减少拒付以及数据丰富的绩效管理。EnableComp 是多年获得 Top Workplaces 奖项的公司,并在 2024 年被 Black Book 评为排名第一的专业收入周期管理解决方案提供商,连续十一年位列 Inc. 5000 快速成长私营企业榜单的前百分之一。
职位概述
第一方汽车理赔收入专员负责调查和分析机动车事故账户,以正确识别和协调保险福利并解决客户的未结余额。该职位会与患者及保险公司密切合作,直至第一方索赔得到处理并达成解决。该职位负责处理患者健康信息(PHI),并在涉及机密和专有信息时保持高度的隐私和安全性。
主要职责
- 使用 EnableComp 的专有软件、系统和工具以及其他在线医学网站,进行机动车事故索赔支付的在线医学研究。
- 研究、请求、获取和审查必要的医疗记录、医生笔记、保险赔付说明和其他支持文件,然后向保险公司提交医院索赔,确保及时正确的索赔报销。
- 及时且彻底地与付款人跟进,更新索赔系统中的准确信息,并确保已收到支持文件,从而促进及时报销,同时做出关键决策。
查看英文原文
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, First Party Auto investigates and analyzes Motor Vehicle Accident accounts in order to properly identify and coordinate insurance benefits and resolve outstanding balances for our clients. This position works closely with the patient as well as insurance carriers until the first party claim has been processed and reached 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.
Key Responsibilities
- Conduct online medical research of Motor Vehicle Accident claim payments using EnableComp’s proprietary software, systems and tools, as well as other online medical websites.
- Research, request, acquire, and review medical records, provider notes, explanation of benefits and any other supporting documentation necessary, and then submit hospital claims to insurance companies to ensure prompt correct claims reimbursement.
- Conduct timely and thorough follow-up with payers to update claim system with accurate information and ensure supporting documentation has been received facilitating prompt reimbursement while making key decisions to ensure claim resolution.
- Prepare correct MVA billing packet using EnableComp systems tools and submit with all necessary supporting documentation to insurance companies.
- Communicate with patients or insurance adjusters via various mediums in order to discuss claim status and probability of timely resolution.
- Review and understand payer EOBs to determine appropriate actions with claim balance after auto insurance claim resolution
- Other duties as required.
Requirements and Qualifications
- High School Diploma or GED required. Associate or bachelor’s Degree preferred.
- 2+ years’ experience in healthcare field working in billing or collections.
- 1+ years’ experience with MVA claim resolution preferred.
- Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
- Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements in relation to MVA and first party auto claims.
- An equivalent combination of education and experience will be considered.
- Regular and predictable attendance.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodation 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 a professional image and provides excellent customer service.
- 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.
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
Originally posted on Himalayas