Qureos Mentor

EnableComp, LLC

<div><div>EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified <i>E360 RCM</i>&trade; intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers&rsquo; Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years.</div><div></div><div><b><br>
Position Summary</b></div><div></div><div><br>
The Revenue Specialist, Medicaid ensures proper submission and adjudication of all claims submitted to Medicaid carriers while working within the deadlines and protocols of the assignments. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.</div>
<h3 class="jobSectionHeader"><b>Key Responsibilities</b></h3><ul><li>
Verify patient eligibility when needed.</li><li>
Analyze and evaluate Medicaid claim payments using the company&rsquo;s systems and tools. Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state fee schedule.</li><li>
Research, request and acquire all pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to ensure prompt correct claims reimbursement.</li><li>
Review technical billing (UB 04) components provided by Client Hospital for accuracy. Make necessary changes as required in accordance with billing laws.</li><li>
Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.</li><li>
Prepare correct Medicaid initial bill packet using EnableComp systems&rsquo; tools and submit with all necessary supporting documentation to insurance companies</li><li>
Analyze all assigned account delinquencies and account activity to ensure timely and accurate payments from appropriate payers.</li><li>
Work with insurers and outside entities through various avenues to verify/request authorizations and assist in concurrent review activities to obtain authorization as needed.</li><li>
File and handle confidential documentation and patient health information (PHI); adhere and follow all HIPAA mandated guidelines.</li><li>
Manage both inbound and outbound calls efficiently and effectively.</li><li>
Assist in efficiently moving work through the department, working as part of a team.</li><li>
Appeal claim denials and/or underpayments as necessary.</li><li>
Other duties as required</li></ul><h3 class="jobSectionHeader"><b>
Requirements and Qualifications</b></h3><ul><li>
High School Diploma or GED required. Associates or Bachelor&rsquo;s Degree preferred.</li><li>
1-2+ years&rsquo; experience in healthcare field working in billing or collections.</li><li>
1+ years&rsquo; client facing/customer services experience.</li><li>
1+ years&rsquo; experience with UB-04 billing and collections required. CMS-1500 billing and other complex claims experience a plus.</li><li>
Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements.</li><li>
Intermediate level understanding of Medicaid payers preferred.</li><li>
Equivalent combination of education and experience will be considered.</li><li>
Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).</li><li>
Regular and predictable attendance.</li><li>
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.</li></ul><h3 class="jobSectionHeader"><b>
Special Considerations and Prerequisites</b></h3><ul><li>
Practices and adheres to EnableComp&rsquo;s Core Values, Vision and Mission.</li><li>
Proven ability to meet and/or exceed productivity targets and goals.</li><li>
Maintains stable performance under pressure or opposition. Handles stress in ways to maintain relationships with all stakeholders.</li><li>
Must be a self-starter and able to work independently without direct supervision.</li><li>
Proven written and verbal communication skills.</li><li>
Strong analytical and problem-solving skills.</li><li>
Proven experience working with external clients; strong customer service skills and business acumen.</li><li>
Ability to prioritize and manage multiple competing priorities and projects concurrently.</li><li>
Must be able to remain in stationary position 50% of the time.</li><li>
Occasionally moves about inside the office to access office equipment, etc.</li><li>
Constantly operates a computer and other office equipment such as a copy/scan/print machine, phone and computer.</li></ul><div><i>
EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.</i></div><div></div><div><br>
EnableComp recruits, develops and retains the industry's top talent. As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people. We believe that <b>investing in our employees is the key to our success</b>, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies. If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.</div><div></div><div><b><i><br>
 </i></b><b><i>Don&rsquo;t just take our word for it! Hear what our people are saying:</i></b></div><div><i>
&ldquo;I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other.&rdquo;</i> &ndash; Revenue Specialist</div><div></div><div><i><br>
&ldquo;I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun.&rdquo;</i> &ndash; Supervisor, Operations</div>
<p>
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.</p></div>

Revenue Specialist, Out of State Medicaid

<div><div>EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified <i>E360 RCM</i>&trade; intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers&rsquo; Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years.</div>
<div></div>
<div><b>Position Summary</b></div><div></div><div><br>
<div>
The Client Support Representative is an operational support role within the Client Support team, responsible for executing core tasks that enable EnableComp&rsquo;s revenue cycle operations. This role focuses primarily on medical documentation retrieval and processing, assisting with inventory reconciliation compilation, and supporting prebill work queue resolution. The Client Support Representative partners with the Client Delivery team to communicate operational findings and escalate client-impacting issues, ensuring seamless coordination across functions. This role does not have direct client interaction; all client communication is facilitated through the Client Delivery team.</div>
</div>
<h3 class="jobSectionHeader"><b>Key Responsibilities</b></h3><ul>
<li>Retrieve and acquire medical documentation from client systems, including but not limited to implant invoices, UB-04 documents, Explanations of Benefits, and medical record components</li>
<li>Submit document request lists and monitor outstanding requests on a regular cadence to ensure EnableComp receives necessary claim documentation for processing</li>
<li>Scan, upload, and store medical documentation and confidential patient health information (PHI) in accordance with EnableComp&rsquo;s data handling standards</li>
<li>Assist in compiling client reconciliations by gathering and organizing data from client systems and EnableComp platforms to prepare reconciliation reports for review and resolution</li>
<li>Assist in working client reconciliations by researching closed and returned claims, resolving open items, posting adjustments, entering refund and payment research requests, and reviewing or rebilling missing claims</li>
<li>Support prebill work queue resolution for assigned clients, maintaining performance within established KPI standards</li>
<li>Partner with Client Delivery team members to communicate operational findings, escalate client-impacting issues, and ensure alignment on inventory and documentation needs</li>
<li>Identify and report client system issues, workflow barriers, and process gaps to the Client Support People Leader for resolution or escalation</li>
<li>Identify and escalate recurrent process gaps that contribute to claims appearing on reconciliations to the Client Support People Leader, supporting upstream resolution by Revenue Services</li>
<li>Maintain accurate and consistent documentation within the E360 platform in real time as actions are completed, ensuring all account activity is properly recorded</li>
<li>Use multiple systems to perform accurate and timely data entry in support of operational workflows</li>
<li>Assist in efficiently moving work through the department and cooperate with other departments as needed</li>
<li>Follow established standard operating procedures (SOPs) and contribute feedback on process improvement opportunities</li>
<li>Other duties as assigned</li>
</ul><h3 class="jobSectionHeader"><b>Requirements and Qualifications</b></h3><div>
<ul><li>High School Diploma or GED required</li>
<li>1+ years of experience in a healthcare operations, revenue cycle, or document management environment preferred</li>
<li>Familiarity with medical claims documentation and payer/provider data processes preferred</li>
<li>Equivalent combination of education and experience will be considered</li>
</ul><ul><li>Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook)</li>
<li>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions.</li>
<li>Regular and predictable attendance</li>
</ul></div><h3 class="jobSectionHeader"><b>Special Considerations and Prerequisites</b></h3><div>
<ul><li>Practices and adheres to EnableComp&rsquo;s Core Values, Vision and Mission</li>
</ul><ul><li>Ability to handle large volumes of work while paying close attention to detail</li>
<li>Ability to work in a fast-paced environment with a strong sense of urgency</li>
<li>Demonstrated ability to work under limited supervision, manage multiple tasks, and prioritize assignments within time constraints</li>
<li>Effectively communicate issues, problems, and results that impact timelines for task completion</li>
<li>Ability to interact professionally at multiple levels within the organization</li>
<li>Strong organizational skills and attention to detail</li>
<li>Willingness to learn and adapt in a dynamic, evolving operational environment</li>
</ul></div><div><i>EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.</i></div>
<div></div>
<div>EnableComp recruits, develops and retains the industry's top talent. As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people. We believe that <b>investing in our employees is the key to our success</b>, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies. If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.</div>
<div></div>
<div><b><i> </i></b><b><i>Don&rsquo;t just take our word for it! Hear what our people are saying:</i></b></div>
<div><i>&ldquo;I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other.&rdquo;</i> &ndash; Revenue Specialist</div>
<div></div>
<div><i>&ldquo;I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun.&rdquo;</i> &ndash; Supervisor, Operations</div>
<p>
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.</p></div>

Client Support Representative

Join EnableComp, LLC and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

EnableComp, LLC

About Company

Revenue Specialist, Out of State Medicaid

Client Support Representative