Experienced Medical Biller, Worker's Compensation (REMOTE)

EnableComp • United States - Remote, TN

4d • Remote

About The Position

The Revenue Specialist acts as the liaison between key client contacts and insurance companies. The role handles protected health information (PHI) and requires maintaining strict privacy and security for confidential and proprietary information.

The position evaluates workers’ compensation claim payments, checks reimbursement against applicable state fee schedules or PPO contracts, gathers supporting records and documentation, and submits claims or appeals to insurers. It also involves follow-up with payers to confirm receipt of documentation and facilitate reimbursement. The role requires strong client service, communication, analytical, organizational, and computer skills, along with the ability to work independently and manage competing priorities.

Requirements

• High school diploma or GED.
• 1–2+ years of experience in a healthcare field working in billing or collections.
• At least 1 year of client-facing or customer-service experience.
• Intermediate understanding of insurance payer/provider claims processing and related data requirements.
• Strong computer proficiency, including basic office applications such as Microsoft Word, Excel, and Outlook.
• Ability to perform each essential duty satisfactorily; reasonable accommodations may be made for qualified individuals with disabilities.
• Ability to meet and/or exceed productivity targets and goals.
• Ability to maintain stable performance under pressure and handle stress while maintaining relationships with stakeholders.
• Ability to work independently without direct supervision.
• Proven written and verbal communication skills.
• Strong analytical and problem-solving skills.
• Experience working with external clients, strong customer-service skills, and business acumen.
• Ability to prioritize and manage multiple competing priorities and projects concurrently.
• Ability to remain in a stationary position 50% of the time and occasionally move about the office to access equipment.
• Ability to operate a computer and other office equipment, including a copy/scan/print machine and phone.

Nice To Haves

• Associate or bachelor’s degree preferred.
• At least 1 year of experience with workers’ compensation billing and collections preferred.
• Equivalent combination of education and experience will be considered.

Responsibilities

• Analyze and evaluate workers’ compensation claim payments using the company’s proprietary software, systems, and tools.
• Use payer payment documentation to determine whether the medical provider was reimbursed in compliance with the applicable state workers’ compensation fee schedule and/or PPO contract.
• Research, request, and acquire pertinent medical records, implant manufacturer invoices, and other supporting documentation; submit them with hospital claims to insurers to support prompt, correct reimbursement.
• Conduct timely and thorough telephone follow-up with payers to confirm receipt of claims and supporting documentation and facilitate reimbursement.
• Prepare workers’ compensation initial bill packets or appeal letters using company systems and tools, and submit them with the required supporting documentation to insurers.
• Perform other duties as required.
• Protect confidential and proprietary information, including PHI.
• Maintain regular and predictable attendance.

Benefits

• The company describes a commitment to employees’ professional growth and development, providing tools, resources, and support to help employees thrive and advance their careers.
• Employee testimonials describe the workplace as family-oriented and flexible, with understanding of work-life balance.

What This Job Offers

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