Key Responsibilities
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
Submit document request lists and monitor outstanding requests on a regular cadence to ensure EnableComp receives necessary claim documentation for processing
Scan, upload, and store medical documentation and confidential patient health information (PHI) in accordance with EnableComp’s data handling standards
Assist in compiling client reconciliations by gathering and organizing data from client systems and EnableComp platforms to prepare reconciliation reports for review and resolution
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
Support prebill work queue resolution for assigned clients, maintaining performance within established KPI standards
Partner with Client Delivery team members to communicate operational findings, escalate client-impacting issues, and ensure alignment on inventory and documentation needs
Identify and report client system issues, workflow barriers, and process gaps to the Client Support People Leader for resolution or escalation
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
Maintain accurate and consistent documentation within the E360 platform in real time as actions are completed, ensuring all account activity is properly recorded
Use multiple systems to perform accurate and timely data entry in support of operational workflows
Assist in efficiently moving work through the department and cooperate with other departments as needed
Follow established standard operating procedures (SOPs) and contribute feedback on process improvement opportunities
- Other duties as assigned
- Requirements and Qualifications
- High School Diploma or GED required
1+ years of experience in a healthcare operations, revenue cycle, or document management environment preferred
Familiarity with medical claims documentation and payer/provider data processes preferred
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)
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.
- Regular and predictable attendance
- Special Considerations and Prerequisites
- Practices and adheres to EnableComp’s Core Values, Vision and Mission
Ability to handle large volumes of work while paying close attention to detail
Ability to work in a fast-paced environment with a strong sense of urgency
Demonstrated ability to work under limited supervision, manage multiple tasks, and prioritize assignments within time constraints
Effectively communicate issues, problems, and results that impact timelines for task completion
Ability to interact professionally at multiple levels within the organization
Strong organizational skills and attention to detail
Willingness to learn and adapt in a dynamic, evolving operational environment
