Follow Up Specialist, Denials

EnableComp • Franklin, TN

1d • Onsite

About The Position

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. The Follow-Up Specialist, Clinical Denials is responsible for managing clinical appeals by engaging with insurance companies, submitting disputes, and ensuring timely resolution. This role involves investigating denial reasons, communicating with payers, and providing supporting documentation to facilitate reconsideration. The specialist works closely with the operations team to escalate appeal denials while independently handling administrative disputes. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.

Requirements

• High School Diploma or GED required.
• 2-3 years’ experience in healthcare field working in billing or collections.
• 1+ years’ customer services experience.
• Knowledge 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).
• Strong interpersonal and communication skills, with the ability to collaborate effectively with team members and cross-functional teams.
• Knowledge of the revenue cycle process.
• Timely and regular attendance.
• 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.

Nice To Haves

• Associates or Bachelor’s Degree preferred.

Responsibilities

• Review denial letters and initiate follow-up actions to confirm and dispute appeal denials.
• Contact insurance companies via phone, payer portals, and email to clarify denial reasons and request reconsideration.
• Submit disputes for denials related to timely filing, missing documentation, or administrative errors.
• Provide supporting documentation such as USPS printouts, fax confirmations, email delivery receipts, and tracking numbers to validate timely appeal submission.
• Monitor outstanding appeals and escalate unresolved cases in accordance with payer contract guidelines.
• Track pending decisions and proactively follow up if no response is received within contractually defined timeframes.
• Maintain detailed records of follow-up efforts, payer responses, and dispute outcomes.
• Delivers excellent outcomes through collaborative teamwork, continuous improvement, and a client-first approach—while contributing to an engaging, positive team culture
• Ability to accept and apply feedback to build proficiency in all responsibilities listed and adapt to changes in processes, priorities, and organizational needs.
• Achieves all established departmental performance and production targets, ensuring work is completed accurately and meets departmental expectations for output and efficiency.
• Other duties as required.

Benefits

• Top Workplaces award recipient
• Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024
• Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years
• Professional growth and development opportunities
• Commitment to building and maintaining a culture centered around fostering professional growth and development

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED