Revenue Specialist, Third Party Claims, MVA (REMOTE)

EnableComp • United States - Remote, TN

3d • Remote

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 Position Summary The Revenue Specialist, Third-Party Claims 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 acts as the liaison between Enablecomp clients, patient attorneys, 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.

Requirements

• High School Diploma or GED required.
• 2+ years’ experience in healthcare field working in billing or collections.
• 2+ years’ client facing/customer services experience.
• 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 motor vehicle claims
• Intermediate level understanding of MVA legal requirements.
• 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.
• 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.
• Attend weekly team meetings to discuss updates/changes such as new hospital procedures or current client issues.
• Communicate any issues through the manager including, but not limited to, systems errors, questions for other departments, HIPAA questions.
• Constantly operates a computer and phone.

Nice To Haves

• Associate or bachelor’s Degree preferred.
• Other complex claims experience a plus.

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 for knowledge of account information.
• Utilizing information to manage claim life cycle and accurately communicate with external patient counsel and insurance providers.
• 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 and patient attorney, with appropriate authorizations.
• Communicate with patient attorney via various mediums in order to discuss claim status and probability of timely resolution.
• Other duties as required.

What This Job Offers

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