Revenue Specialist First Party Auto MVA
EnableComp
Description
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM⢠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, Workersâ 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.
Position Summary
The Revenue Specialist, First Party Auto investigates and analyzes Motor Vehicle Accident accounts in order to properly identify and coordinate insurance benefits and resolve outstanding balances for our clients. This position works closely with the patient as well as insurance carriers until the first party claim has been processed and reached resolution. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.
\n- Conduct online medical research of Motor Vehicle Accident claim payments using EnableCompâs proprietary software, systems and tools, as well as other online medical websites.
- Research, request, acquire, and review medical records, provider notes, explanation of benefits and any other supporting documentation necessary, and then submit hospital claims to insurance companies to ensure prompt correct claims reimbursement.
- Conduct timely and thorough follow-up with payers to update claim system with accurate information and ensure supporting documentation has been received facilitating prompt reimbursement while making key decisions to ensure claim resolution.
- Prepare correct MVA billing packet using EnableComp systems tools and submit with all necessary supporting documentation to insurance companies.
- Communicate with patients or insurance adjusters via various mediums in order to discuss claim status and probability of timely resolution.
- Review and understand payer EOBs to determine appropriate actions with claim balance after auto insurance claim resolution
- Other duties as required.
- High School Diploma or GED required. Associate or bachelorâs Degree preferred.
- 2+ yearsâ experience in healthcare field working in billing or collections.
- 1+ yearsâ experience with MVA claim resolution preferred.
- Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
- Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements in relation to MVA and first party auto claims.
- An equivalent combination of education and experience will be considered.
- Regular and predictable attendance.
- 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.
- Practices and adheres to EnableCompâs Core Values, Vision, and Mission.
- Proven ability to meet and/or exceed productivity targets and goals.
- Maintains a professional image and provides excellent customer service.
- Maintains stable performance under pressure or opposition. Handles stress in ways to maintain relationships with all stakeholders.
- 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.
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About EnableComp
Company hiring for Vice President Client Success West
Job Stats
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Interview Prep Guide
Preparation Strategy
To prepare for this role, review the company's website and E360 RCM platform to understand their approach to revenue cycle management. Practice answering behavioral questions using the STAR method, and be prepared to discuss your experience with healthcare billing and collections. Additionally, brush up on your knowledge of insurance regulations and policies, and be prepared to discuss your experience with MS Office and other relevant software. It's also essential to review the company's values and mission to understand their culture and expectations.
Likely Interview Rounds
- 1. Screening call~30 min
What to prep: Review the company's E360 RCM platform and be prepared to discuss your experience with healthcare billing and collections, particularly with MVA claims.
- What experience do you have with MVA claim resolution?
- How would you handle a difficult insurance adjuster?
- Can you walk me through your process for researching and submitting hospital claims?
- 2. Technical~60 min
What to prep: Brush up on your knowledge of insurance payer/provider claims processing, and be prepared to discuss your experience with MS Office and other relevant software.
- How do you stay up-to-date with changing insurance regulations and policies?
- What tools or software have you used for medical billing and claims processing?
- Can you explain the difference between first-party and third-party insurance claims?
- 3. Behavioral~60 min
What to prep: Review the company's values and mission, and be prepared to discuss your experience working in a fast-paced environment with sensitive information.
- Tell me about a time when you had to communicate complex information to a patient or insurance adjuster.
- How do you handle confidential and proprietary information?
- Can you describe a situation where you had to troubleshoot an issue with a claim?
Most Likely Questions
- What do you know about our company and our E360 RCM platform?
- How would you handle a denied claim?
- Can you explain the process for researching and submitting hospital claims?
- How do you stay organized and manage multiple claims at once?
- What experience do you have with patient health information and confidentiality?
Common Pitfalls
- Lack of attention to detail when reviewing medical records and claims
- Inadequate communication with patients or insurance adjusters
- Insufficient knowledge of insurance regulations and policies
- Failure to maintain confidentiality and security of patient health information
Free Prep Resources
- • AAPC (American Academy of Professional Coders) website
- • AHIMA (American Health Information Management Association) website
- • Microsoft Office tutorials