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Revenue Specialist, Denials

Enablecomp · Franklin, TN

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, 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. 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, Denials acts as the liaison between key client contacts and our denials appeal process to the appropriate payer. The Revenue Specialist, Denials is responsible for the initial denial audit and activities to resolve outstanding claims. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information. Key Responsibilities • Review and evaluate Denied and other assigned claims using EnableComp's proprietary software, systems and tools. Use payment documentation provided by payers and medical provider contract information to determine the correct reimbursement. • Research, request and acquire all pertinent medical records and any other supporting documentation necessary and then submit with hospital claims to the appropriate payer to ensure prompt correct claims reimbursement. • Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement. • Other duties as required. Requirements and Qualifications • High School Diploma or GED required. Associates or Bachelor's 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 subsequent data requirements. • 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). • Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology. • Strong understanding of the revenue cycle process. • Full understanding of hospital reimbursement, Intermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements. • Familiarity with HMO, PPO, IPA, and capitation terms and how these payors process claims. • Intermediate understanding of EOB, hospital billing form requirements (UB04), and familiarity with the HCFA 1500 forms. • Demonstrate strong ability to review client/payer contracts to identify complex underpayments. • Regular and predictable attendance. • 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. Special Considerations and Prerequisites • Practices and adheres to EnableComp's Core Values, Vision and Mission. • Proven ability to meet and/or exceed productivity targets and goals. • 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. • Proven experience working with external clients; strong customer service skills and business acumen. • Ability to prioritize and manage multiple competing priorities and projects concurrently. • Must be able to remain in stationary position 50% of the time. • Occasionally moves about inside the office to access office equipment, etc. • Constantly operates a computer and other office equipment such as a copy/scan/print machine, phone and computer. 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. 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 investing in our employees is the key to our success, 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. Don't just take our word for it! Hear what our people are saying: "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." - Revenue Specialist "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." - Supervisor, Operations

Director, Client Success - Revenue Cycle - (REMOTE)

Enablecomp · Franklin, TN

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, 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. 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 Director, Client Success, is responsible for managing and growing client relationships through hands on partnership and collaboration with both EnableComp operations and sales leadership. This role focuses on delivering exceptional service, aligning client expectations with internal capabilities, and driving satisfaction and retention through consistent, proactive communication. The Director acts as an extension of the client, translating needs into actionable plans, resolving challenges, and identifying opportunities to enhance performance and expand market share through consistent service that exceeds client expectations. Key Responsibilities • Participate in entirety of Client Lifecycle. Sales process, Implementations, Project Go Lives, Business Reviews, and identify additional Cross Sell opportunities • Will oversee Client Success activities for designated clients. • Communicate and coordinate with EnableComp Leadership to ensure all job duties as assigned are executed professionally and timely in accordance with EnableComp standard. • Acts as an "ambassador" for a fast-paced, detail oriented supportive team by facilitating friendly, courteous, efficient, and well-presented service to assigned clients. • Manages KPI metrics including, but not limited to, customer surveys, scoring and client retention goals. • Reviews, understands and tracks assigned client's performance goals and meets regularly with assigned clients to review their status and progress with an emphasis on highlighting EnableComp's value proposition and ROI across product lines. • Generates EnableComp's monthly and quarterly reporting packages, delivers to assigned clients timely, and ensures they consistently reflect the pertinent EnableComp metrics and benchmarks. • Collaborates with internal teams to develop and implement client specific strategies and action plans for communication, resolution of open internal/external items and maximization of current and future revenue, including the identification of cross-sell opportunities. • Works closely with IT and Product Support teams regularly on file corrections, updates, and automation. • Schedules and attends regular meetings or conference calls with assigned clients to discuss status and reports and ensures the necessary EnableComp team members contribute appropriately. • Develops agendas and other presentation materials, create meeting summaries and generate meeting deliverables. • Assists Implementation with the roll-out of any process update/rollout initiatives and manage client deliverables post-implementation. • Manages and controls client obligations, maintaining a high level of customer satisfaction at all levels of the organization. • Participates in internal client account review meetings (sales forecast, at risk, etc.). • Use of independent judgement and discretion as it relates to responsibilities detailed above. • Other duties as required. Requirements & Qualifications • Bachelor's Degree in Business, Sales/Marketing or other related field of study • Must have 7-10 years demonstrated experience in account management in the healthcare technology industry, specifically engaging hospital revenue cycle management. • Equivalent combination of education and experience will be considered. • Experience with claims billing and IT/EDI systems preferred. • Experience with CRM software (e.g. Salesforce.com) • 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 accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Key Considerations & Prerequisites • Effective polished professional presentation skills for developing/communicating analytics, results and ROI to all stakeholders. • Strong passion for serving the needs and expectations of the client. • Must be a self-starter and able to work independently as well as partner and collaborate with internal departments and leaders. • Excellent written and oral communication skills to communicate with internal stakeholders and external clients. • Demonstrated experience managing stressful situations effectively through difficult conversations, communicating obstacles, challenges and developing action plans to present to management. • Demonstrates a consultative relationship style both internally and externally; is a team player and has a positive-can-do attitude. • Strong analysis and problem-solving skills. • Must be able to manage conflicting priorities, while being extremely adaptable and flexible. • Up to 30% travel required. 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. 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 investing in our employees is the key to our success, 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. Don't just take our word for it! Hear what our people are saying: "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." - Revenue Specialist "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 an

Revenue Specialist, OSM

Enablecomp · Franklin, TN

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, 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. 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, 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. Key Responsibilities • Verify patient eligibility when needed. • Analyze and evaluate Medicaid claim payments using the company'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. • 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. • Review technical billing (UB 04) components provided by Client Hospital for accuracy. Make necessary changes as required in accordance with billing laws. • Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement. • Prepare correct Medicaid initial bill packet using EnableComp systems' tools and submit with all necessary supporting documentation to insurance companies • Analyze all assigned account delinquencies and account activity to ensure timely and accurate payments from appropriate payers. • Work with insurers and outside entities through various avenues to verify/request authorizations and assist in concurrent review activities to obtain authorization as needed. • File and handle confidential documentation and patient health information (PHI); adhere and follow all HIPAA mandated guidelines. • Manage both inbound and outbound calls efficiently and effectively. • Assist in efficiently moving work through the department, working as part of a team. • Appeal claim denials and/or underpayments as necessary. • Other duties as required Requirements and Qualifications • High School Diploma or GED required. Associates or Bachelor's Degree preferred. • 1-2+ years' experience in healthcare field working in billing or collections. • 1+ years' client facing/customer services experience. • 1+ years' experience with UB-04 billing and collections required. CMS-1500 billing and other complex claims experience a plus. • Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements. • Intermediate level understanding of Medicaid payers 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). • Regular and predictable attendance. • 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. Special Considerations and Prerequisites • Practices and adheres to EnableComp's Core Values, Vision and Mission. • Proven ability to meet and/or exceed productivity targets and goals. • 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. • Proven experience working with external clients; strong customer service skills and business acumen. • Ability to prioritize and manage multiple competing priorities and projects concurrently. • Must be able to remain in stationary position 50% of the time. • Occasionally moves about inside the office to access office equipment, etc. • Constantly operates a computer and other office equipment such as a copy/scan/print machine, phone and computer. 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. 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 investing in our employees is the key to our success, 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. Don't just take our word for it! Hear what our people are saying: "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." - Revenue Specialist "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." - Supervisor, Operations

Sales Incoming Leads Only | Inc.500 What our team says: “I came here looking for a job and I found a career.” — Abigail, Hired in 2022 “Only regret I have is that I didn't start with Wesley SOONER!! This is the last sales job I hope I ever have.” — Chris, Hired in 2018 “I've done sales elsewhere, but Wesley is in a league of its own! This is exactly what a sales role should look like! Working here reminded me why I fell in love with sales in the first place!” — Darrin, Hired in 2021 This job is only available to seasoned sales pros that want to work for a 2020 INC 500 company offering base pay + commissions + monthly bonuses + 401k match + health benefits, and more… …and that only wants INCOMING leads. Because we don't do cold calling. Ever! (We spend over $2M/month on ads to generate the leads YOU call as they come in.) That's why we are looking for top 5% sales talent — we are not looking for average. Our top 10% in this role earned $140,000 – $160,000 in 2025. Enjoy a full time work schedule with an environment that leaves you genuinely feeling good about the work you're doing. All with some very unique benefits… New employees receive: • MacBook to complete work tasks • Base Salary + Commissions (We pay weekly) • 401k program with company match • Medical, Dental, and Vision Insurance Benefits • Generous paid time off • Access to our office's facilities: world-class onsite fitness center, walking trails, natural courtyard with wifi, food center • A diverse culture like no other: food trucks, relaxed team-building lounge areas, and the occasional foosball tournament • Continuous coaching from industry professionals • Massage Chairs to be able to relax and reset The world is changing – we often seem to find ourselves not just looking for a career that gives us the opportunity for growth, but for a career that lets us feel good about the work we do and… get to have fun doing it! Wesley Financial Group, LLC is a company based in Franklin, Tennessee that helps timeshare owners who have been misled get out of their timeshare. Wesley is a national company listed on the INC 500 in 2020. Job Summary You will be responsible for contacting, qualifying, and scheduling sales appointments for timeshare owners who have requested help in canceling their timeshare with Wesley Financial Group, LLC. IMPORTANT: Every lead called is a warm lead that has expressed interest in our services. Our fully staffed marketing team provides leads (currently more than 3,000/week). There is no cold calling. The ideal person for this job is a successful salesperson who has a track record of hitting sales targets and is extremely well organized, highly motivated, and has a positive attitude. Essential Duties & Responsibilities (including, but not limited to) • Call leads in an efficient and timely manner • Ask questions to understand the prospect's situation with their timeshare and pre-qualify them for our services • Explain the value and process of working with Wesley Financial Group, LLC • Schedule appointments • Input client information into Salesforce Requirements • Strong computer skills • 2-3 years of sales experience (Telesales preferred) • Salesforce experience preferred • Excellent communication skills (verbal and written) • Ability to work independently in a fast-paced environment Compensation • Base pay • Uncapped commission with top 10% earning $140,000 – $160,000 in 2025 • Monthly bonuses (close to 50% hit bonus on average) • Commissions paid weekly Benefits • 401k match • Comprehensive benefits package: medical, dental, and vision plans, company-paid short-term disability, life insurance, parental leave, and employer-funded HSA Schedule Full Time | Monday – Thursday, 9:00am – 7:00pm Onsite, in office at Franklin, TN HQ (4 x 10 hr shifts — OFF on Fridays) Why Wesley?Wesley Financial Group, LLC has been in business for over 10 years. We are a 300+ employee company with a platinum rating through Dun & Bradstreet and were ranked on INC 500 in 2020 as the 203rd fastest-growing privately held company in the U.S. We've won over 75 business awards since 2020, including: • 2023 Great Place To Work Certified • 2023 Business Intelligence Group – Excellence in Sales & Marketing • 2022 Inc. 5000 Fastest Growing Company • 2021 Gold Stevie Award – Fastest Growing Company • 2021 Fortune Magazine – Best Workplaces for Women • 2021 Nashville Business Journal – Best Places to Work • 2021 CEO Views – Top 50 Best Companies of the Year • 2020-21 Inc. 500 Fastest Growing Company • 2020 Fortune Magazine – Best Places Workplaces Millenials • 2020 Business Intelligence Group – Best Places to Work Aside from business accolades, Wesley Financial Group is strongly dedicated to giving back to the community. Through donations and volunteer work, we always strive to help others whether through our services or through our charitable work. Additional PERKS for being a Wesley Employee: • Leadership training and advancement opportunities • Robust employee recognition programs • Ability to participate in company-wide community outreach programs • Competitive wages and bonuses • Generous PTO • 9 paid holidays • 2 floating holidays • Great work/life balance • Open communication: monthly town hall meetings • Spirited and passionate team environment with members who display core values of teamwork and integrity • A welcome box of Wesley swag Wesley is an Equal Opportunity Employer. We verify employment eligibility for all new hires using E-Verify. #nashville Schedule Full Time | Monday – Thursday, 9:00am – 7:00pm Onsite, in office at Franklin, TN HQ (4 x 10 hr shifts — OFF on Fridays) Compensation details: 140000-160000 Yearly Salary PI0d1c8c6dc946-31181-40938273