Revenue Specialist, Denials

EnableComp

. Review and evaluate Denied and other assigned claims using EnableComp’s proprietary software, systems and tools .

Posted 7/22/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare billing and collections, with a strong understanding of insurance claims processing, reimbursement methodologies, and medical coding. Proficient in utilizing proprietary software and MS Office applications to manage claims and documentation effectively.

Highest-signal resume keywords

Healthcare Billing ExperienceClaims Processing KnowledgeICD, HCPCS/CPT CodingRevenue Cycle UnderstandingClient Facing/Customer Service Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims EvaluationReimbursement DeterminationMedical Record AcquisitionEOB UnderstandingHospital Billing Form Requirements

Soft Skills

Strong CommunicationAttention to DetailProblem Solving

Tools & Technologies

EnableComp SoftwareMS Office (Word, Excel, Outlook)

Industry Keywords

Managed Care ContractsHMOPPOIPACapitation

About the role

Key responsibilities & impact

Review and evaluate Denied and other assigned claims using EnableComp’s proprietary software, systems and tools
Use payment documentation provided by payers and medical provider contract information to determine the correct reimbursement
Research, request and acquire 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
Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement
Other duties as required

Requirements

What you’ll need

High School Diploma or GED required
Associates or Bachelor’s Degree preferred
5+ years’ experience in healthcare field working in billing or collections
1+ years’ client facing/customer services experience
Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements
Equivalent combination of education and experience will be considered
Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook)
Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology
Strong understanding of the revenue cycle process
Full understanding of hospital reimbursement, Intermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements
Familiarity with HMO, PPO, IPA, and capitation terms and how these payors process claims
Intermediate understanding of EOB, hospital billing form requirements (UB04), and familiarity with the HCFA 1500 forms
Demonstrate strong ability to review client/payer contracts to identify complex underpayments
Regular and predictable attendance

Benefits

Comp & perks

EnableComp is an Equal Opportunity Employer M/F/D/V
Committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment
Culture centered around fostering the professional growth and development of our people
Continuous commitment to investing in our employees’ success