lever
Superivsor, OSM
EnableComp
Remote, USA
Full-time
Senior · 5+ years experience
Remote
Discovered 2 weeks ago
Free
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- Responsible for the daily supervision of assigned Revenue Services teams.
- Serves as the primary escalation point, to directly or through staff, work with clients to resolve roadblocks that may hinder the claims resolution process and provides direction to Account Managers and Revenue Specialists to resolve existing claims/ client issues.
- Partners with Managers to disseminate priority of daily tasks to assigned team.
- Prepares performances evaluations and account reviews and plays a role in delivering both documents in conjunction with the Department Leader.
- Analyze and evaluate claim payments using EnableComp’s proprietary software, systems and tools. Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state worker’s compensation fee schedule and/or PPO contract.
- Research, request and acquire all pertinent medical records, implant manufacturer’s invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement.
- Manage internal coordination, communication, and messaging for external client requests and reported issues.
- Create, review, and maintain external-facing client reports.
- Facilitate internal and external meetings to discuss process improvements, resolve client issues, and/or resolve internal issues.
- Respond and communicate with external clients regarding topics such as: remote system access, document requests, payment research requests, coordination of end-user training, and others.
- Conduct timely and thorough telephone follow-up with insurance companies to ensure proper reimbursement.
- Prepare correct initial bill packet or appeal letter using EnableComp systems tools.
- Works with Data Analytics team to research issues with claim and payment imports, etc.
- Trains and mentors staff as needed including new hires, especially in regards to ongoing training needs that may result from the SOP for goal escalation.
- Works with Data Quality team to research issues with calculations and other projects.
- Works with Document Management team to remove roadblocks around document acquisition and other requisite items needed to collect accounts.
- Perform Quality Control tasks on behalf of management regarding account flow and due diligence.
- Usually works more difficult clients.
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