收入专员,工伤补偿
Revenue Specialist, Worker's Compensation
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,包括美国退伍军人事务部、工伤赔偿、机动车事故和跨州医疗补助索赔,以及所有付款方类别的拒付问题。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、减少拒付和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,是过去十一年中跻身 Inc. 5000 快速增长私营企业榜单的前百分之一的公司。
职位概述
收入专员作为关键客户联系人与保险公司之间的联络人。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极高的隐私和安全性。
主要职责
- 使用 EnableComp 的专有软件、系统和工具分析和评估工伤赔偿索赔支付情况。利用付款方提供的支付文件,确定医疗提供者是否按照适用的州工伤赔偿费用表和/或 PPO 合同进行报销。
- 研究、请求并获取所有相关的医疗记录、植入物制造商的发票和其他必要的支持文件,然后与医院索赔一起提交给保险公司,以确保及时正确的索赔报销。
- 及时且彻底地与付款方进行电话跟进,确保带有支持文件的索赔已收到并促进及时报销。
- 使用 EnableComp 系统工具准备正确的工伤赔偿初始账单包或上诉信,并附上所有必要的支持文件提交给保险公司。
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 acts as the liaison between key client contacts and insurance companies. 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
- 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.
- 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.
- Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.
- Prepare correct Workers’ Comp initial bill packet or appeal letter using EnableComp systems tools and submit with all necessary supporting documentation to insurance companies
- 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 workers compensation billing and collections a preferred.
- Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements.
- Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
- 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.
- Regular and predictable attendance.
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
Originally posted on Himalayas