Revenue Specialist, First Party Billing

Job Description:

• Investigate and analyze Motor Vehicle Accident accounts to identify and coordinate insurance benefits and resolve outstanding client balances
• Work closely with patients and insurance carriers until first-party claims are processed and resolved
• Handle patient health information (PHI) while maintaining strict privacy and security of confidential and proprietary information
• Conduct online medical research of MVA claim payments using EnableComp’s proprietary software, systems, tools, and other medical websites
• Research, request, acquire, and review medical records, provider notes, explanations of benefits, and supporting documentation
• Submit hospital claims to insurance companies to ensure prompt and accurate reimbursement
• Follow up with payers to update claim systems accurately and verify receipt of supporting documentation
• Make key decisions to facilitate claim resolution
• Prepare accurate MVA billing packets and submit them with required documentation
• Communicate with patients and insurance adjusters regarding claim status and timely resolution prospects
• Review payer EOBs and determine appropriate actions for claim balances after auto insurance claim resolution
• Perform other duties as required

Requirements:

• High School Diploma or GED required
• Associate or bachelor’s Degree preferred
• 2+ years’ experience in healthcare field working in billing or collections
• 1+ years’ experience with MVA claim resolution preferred
• Strong computer proficiency
• Basic office applications, including MS Office (Word, Excel, and Outlook)
• Intermediate understanding of insurance payer/provider claims processing and related data requirements for MVA and first party auto claims
• An equivalent combination of education and experience will be considered
• Regular and predictable attendance
• Ability to perform each essential duty satisfactorily
• Proven ability to meet and/or exceed productivity targets and goals
• Professional image and excellent customer service
• Ability to maintain stable performance under pressure or opposition
• Ability to handle stress while maintaining stakeholder relationships
• Self-starter able to work independently without direct supervision
• Proven written and verbal communication skills
• Strong analytical and problem-solving skills

Benefits:

• Full-time employment
• Professional growth and development opportunities
• Tools, resources, and support for career growth
• Flexible, family-oriented workplace
• Work-life balance support
• Equal opportunity employment