Revenue Specialist – Commercial Billing – Mva

Revenue Specialist – Commercial Billing – Mva

Requirements

• High School Diploma or GED required.
• 2+ years’ experience in healthcare field working in billing or collections. EMR/Billing system experience required.
• 2+ years’ client facing/customer services experience.
• 1+ years’ experience with Health Insurance/Government Insurance claim resolution required.
• 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 motor vehicle claims
• Intermediate level understanding of Health Insurance/Government insurance claims processing
• Basic level understanding of MVA legal requirements
• An equivalent combination of education and experience will be considered.
• Regular and predictable attendance.

Responsibilities

• Conduct online medical research of Motor Vehicle Accident claim and Health Insurance claims 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 for knowledge of account information. Utilizing information to manage claim life cycle and accurately communicate insurance carriers.
• Review accounts take steps to resolve for payment by contacting payers for claim status, rebilling when necessary, and escalating issues when needed.
• Responsible for thorough and timely claim and resolution for HI/GI account receivables.
• Review and Resolve denied claims by submitting corrected claims and filing appeals.
• Communicate with various parties to discuss coordination of insurance benefits, claim status, and additional needs to facilitate claim adjudication.
• Review and analyze health insurance remittance to ensure proper claim adjudication, work with payers to resolve underpayments.
• Identify and alert leadership of denial trends to assist in denial prevention efforts.
• Other duties as required.

Preferred Qualifications

• 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.
• Proven experience working with external clients; strong customer service skills and business acumen.