Revenue Specialist, Denials

The Revenue Specialist, Denials acts as the liaison between key client contacts and our denials appeal process to the appropriate payer. The Revenue Specialist, Denials is responsible for the initial denial audit and activities to resolve outstanding claims. 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 include reviewing and evaluating denied and other assigned claims using EnableComp’s proprietary software, systems and tools; using payment documentation provided by payers and medical provider contract information to determine the correct reimbursement; researching, requesting and acquiring all pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to the appropriate payer to ensure prompt correct claims reimbursement; conducting timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement; and other duties as required.