Revenue Specialist, First Party Auto, MVA

Revenue Specialist, First Party Auto

Company: EnableComp
Location: (Not specified, likely US-based given context)

About EnableComp:
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of expertise and its unified E360 RCM™ intelligent automation platform. We improve financial sustainability for hospitals, health systems, and ambulatory surgery centers nationwide. Our solutions cover Veterans Administration, Workers’ Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims, as well as denials for all payer classes. EnableComp is a multi-year recipient of the Top Workplaces award and recognized as Black Book’s #1 Specialty Revenue Cycle Management Solution provider in 2024.

Position Summary:
The Revenue Specialist, First Party Auto investigates and analyzes Motor Vehicle Accident (MVA) accounts to properly identify and coordinate insurance benefits and resolve outstanding balances for clients. This position works closely with patients and insurance carriers until the first-party claim is processed and resolved. You will handle patient health information (PHI) with extreme privacy and security.

Key Responsibilities:

• Conduct online medical research of MVA claim payments using EnableComp’s proprietary software, systems, and tools, as well as other online medical websites.
• Research, request, acquire, and review medical records, provider notes, explanation of benefits (EOBs), and any other supporting documentation.
• Submit hospital claims to insurance companies to ensure prompt and correct reimbursement.
• Conduct timely and thorough follow-up with payers to update claim systems with accurate information and ensure supporting documentation is received, facilitating prompt reimbursement.
• Make key decisions to ensure claim resolution.
• Prepare correct MVA billing packets using EnableComp systems and tools, submitting them with all necessary supporting documentation to insurance companies.
• Communicate with patients or insurance adjusters via various mediums to discuss claim status and probability of timely resolution.
• Review and understand payer EOBs to determine appropriate actions with claim balances after auto insurance claim resolution.
• Other duties as required.

Requirements and Qualifications:

• High School Diploma or GED required; Associate or Bachelor’s Degree preferred.
• 2+ years of experience in the healthcare field working in billing or collections.
• 1+ years of experience with MVA claim resolution preferred.
• Strong computer proficiency, including MS Office (Word, Excel, and Outlook).
• Intermediate understanding of insurance payer/provider claims processing and subsequent data requirements related to MVA and first-party auto claims.
• An equivalent combination of education and experience will be considered.
• Regular and predictable attendance is required.

Special Considerations and Prerequisites:

• Adheres to EnableComp’s Core Values, Vision, and Mission.
• Proven ability to meet or exceed productivity targets and goals.
• Maintains a professional image and provides excellent customer service.
• Maintains stable performance under pressure and handles stress constructively.
• Must be a self-starter and able to work independently without direct supervision.
• Proven written and verbal communication skills.
• Strong analytical and problem-solving skills.
• EnableComp is an Equal Opportunity Employer M/F/D/V.