Resolution Analyst, Denials
Not Disclosed•Full-TimeOn-site
location_on342, West 30th Street, Chelsea District, Manhattan Community Board 4, Manhattan, New York County, New York, 10001, United States
About EnableComp
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. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp serves Veterans Administration, Workers 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. A multi-year recipient of the Top Workplaces award, EnableComp 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.
About the Role
The Resolution Analyst acts as the vital liaison between key client contacts and the denials and underpayment appeal process with appropriate payers. This role is designed to facilitate payment review recovery efforts for denied and underpaid accounts, directly contributing to the department's revenue growth. You will navigate the complexities of the revenue lifecycle, ensuring that patient health information (PHI) is handled with extreme privacy and security.
In this position, you will manage the full spectrum of claim resolution, from reviewing and evaluating outstanding claims to conducting thorough telephone follow-ups with payers. Your work ensures that complex underpayment appeals are submitted accurately and timely, utilizing medical records and contract information to secure correct reimbursement. Success in this role requires maintaining smooth operations and driving customer satisfaction while adhering to strict productivity targets.
Our Culture
EnableComp recruits, develops, and retains the industry's top talent. As the employer of choice in the complex claims industry, we take pride in our continuous commitment to building a culture centered around fostering professional growth and development. We believe that investing in our employees is the key to our success, providing them with the tools, resources, and support needed to thrive.
Our team is defined by a genuine spirit of cooperation and shared goals. As one of our Revenue Specialists noted, "Everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth." Another team member highlighted our family-oriented environment: "EnableComp stands true to these values from empowering employees to ecstatic clients. This company is flexible, along with understanding the balance of work, life, and fun."
Equal Opportunity Employer
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 status, disability, or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.
Work location
Work model: On-site
342, West 30th Street, Chelsea District, Manhattan Community Board 4, Manhattan, New York County, New York, 10001, United States
New York, New York
Key Responsibilities
- check_circleReview, evaluate, appeal, and follow up on outstanding, denied, and underpaid claims using proprietary software
- check_circleResearch and acquire medical records to create and submit complex underpayment appeals to payers
- check_circleReview hospital contracts to identify and collect cash payments from insurance companies for denied claims
- check_circleAct as liaison between client contacts and the denials and underpayment appeal process
- check_circleMaintain strict privacy and security standards for all patient health information and proprietary data
- check_circleAnalyze payment documentation and medical provider contracts to determine correct reimbursement amounts
- check_circleConduct telephone follow-ups with payers to ensure receipt of documentation and resolve outstanding receivables
Requirements
- verifiedHigh School Diploma or GED required
- verifiedAssociates or Bachelors Degree preferred
- verified5+ years experience in healthcare field working in billing or collections
- verified1+ years client facing/customer services experience
- verifiedIntermediate level understanding of insurance payer/provider claims processing
- verifiedStrong computer proficiency and MS Office (Word, Excel, Outlook)
- verifiedIntermediate understanding of ICD, HCPCS/CPT coding, and medical terminology
- verifiedStrong understanding of the revenue cycle process
- verifiedFull understanding of hospital reimbursement
- verifiedIntermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements
Nice to Have
Associates or Bachelors Degree
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Skills, education and keywords
Skills: MS Office, Word, Excel, Outlook, Icd, HCPCS, CPT, Medical Terminology, Revenue Cycle, Managed Care.
Education: High School Diploma or GED required; Associates Degree preferred; Bachelors Degree preferred.
Frequently asked questions about Resolution Analyst, Denials at EnableComp
What does a Resolution Analyst, Denials at EnableComp do?expand_more
In this Resolution Analyst, Denials at EnableComp role, you will review, evaluate, appeal, and follow up on outstanding, denied, and underpaid claims using proprietary software; research and acquire medical records to create and submit complex underpayment appeals to payers; review hospital contracts to identify and collect cash payments from insurance companies for denied claims; and act as liaison between client contacts and the denials and underpayment appeal process.
What are the requirements for this Resolution Analyst, Denials role?expand_more
To qualify for the Resolution Analyst, Denials at EnableComp position, applicants should have: High School Diploma or GED required; Associates or Bachelors Degree preferred; 5+ years experience in healthcare field working in billing or collections; 1+ years client facing/customer services experience; Intermediate level understanding of insurance payer/provider claims processing; and Strong computer proficiency and MS Office (Word, Excel, Outlook).
Where is the Resolution Analyst, Denials role at EnableComp located?expand_more
Resolution Analyst, Denials at EnableComp is based in 342, West 30th Street, Chelsea District, Manhattan Community Board 4, Manhattan, New York County, New York, 10001, United States. This is a on-site role.
Is this Resolution Analyst, Denials job remote, hybrid, or on-site?expand_more
EnableComp has listed this Resolution Analyst, Denials role as on-site.
How much experience is required for this Resolution Analyst, Denials role?expand_more
Resolution Analyst, Denials at EnableComp typically requires 5+ years of relevant experience at the mid level level.
What skills do you need for the Resolution Analyst, Denials role at EnableComp?expand_more
Key skills for Resolution Analyst, Denials at EnableComp include MS Office; Word; Excel; Outlook; Icd; HCPCS; CPT; and Medical Terminology.
What education is required for Resolution Analyst, Denials at EnableComp?expand_more
Educational requirements for this role: High School Diploma or GED required; Associates Degree preferred; and Bachelors Degree preferred.
What category does the Resolution Analyst, Denials role belong to?expand_more
Resolution Analyst, Denials at EnableComp is part of the accounting & finance job category on Recrutus.