Revenue Specialist, First Party Billing

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Conduct investigations and analyses of Motor Vehicle Accident accounts to identify, coordinate insurance benefits, and resolve outstanding balances for clients.

• Collaborate closely with patients and insurance carriers to ensure the processing and resolution of first-party claims.

• Manage patient health information (PHI) while upholding strict privacy and security protocols for confidential and proprietary data.

• Perform online medical research on MVA claim payments utilizing EnableComp’s proprietary software, systems, tools, and other medical websites.

• Investigate, request, obtain, and review medical records, provider notes, explanations of benefits, and supporting documentation.

• Submit hospital claims to insurance companies to guarantee prompt and accurate reimbursement.

• Follow up with payers to accurately update claim systems and verify the receipt of supporting documentation.

• Make critical decisions to expedite claim resolution.

• Prepare precise MVA billing packets and submit them along with the required documentation.

• Communicate with patients and insurance adjusters about claim status and prospects for timely resolution.

• Review payer EOBs and determine appropriate actions for claim balances after the resolution of auto insurance claims.

• Perform additional duties as required.

⛳️ Requirements

• High School Diploma or GED is mandatory.

• An Associate or Bachelor’s Degree is preferred.

• A minimum of 2 years of experience in the healthcare field, specifically in billing or collections.

• At least 1 year of experience with MVA claim resolution is preferred.

• Strong proficiency in computer skills.

• Familiarity with 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 is essential.

• Ability to satisfactorily perform each essential duty.

• Proven capability to meet and/or exceed productivity targets and goals.

• Professional demeanor and outstanding customer service skills.

• Ability to maintain consistent performance under pressure or opposition.

• Capacity to manage stress while fostering stakeholder relationships.

• Self-motivated individual capable of working independently without direct supervision.

• Demonstrated written and verbal communication skills.

• Strong analytical and problem-solving abilities.

🏝️ Benefits

• Full-time employment.

• Opportunities for professional growth and development.

• Access to tools, resources, and support for career advancement.

• Flexible, family-oriented work environment.

• Support for work-life balance.

• Commitment to equal opportunity employment.