Follow Up Specialist, Denials

@ EnableComp
EnableCompenablecomp.com

Follow Up Specialist, Denials

Posted today

About the job

EnableComp provides healthcare revenue cycle management solutions, focusing on denials, appeals, and claims optimization to improve financial outcomes for health organizations.

Requirements

  • Healthcare billing or collections experience
  • 2-3 years in healthcare field
  • Customer service experience
  • Knowledge of claims processing
  • Computer proficiency

Qualifications

  • High School Diploma or GED
  • Associate or Bachelor’s preferred
  • Strong communication skills
  • Ability to work independently
  • Timely attendance

Full job 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, 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 Follow-Up Specialist, Clinical Denials is responsible for managing clinical appeals by engaging with insurance companies, submitting disputes, and ensuring timely resolution. This role involves investigating denial reasons, communicating with payers, and providing supporting documentation to facilitate reconsideration. The specialist works closely with the operations team to escalate appeal denials while independently handling administrative disputes. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.


JOB RESPONSIBILITIES

  • Review denial letters and initiate follow-up actions to confirm and dispute appeal denials.
  • Contact insurance companies via phone, payer portals, and email to clarify denial reasons and request reconsideration.
  • Submit disputes for denials related to timely filing, missing documentation, or administrative errors.
  • Provide supporting documentation such as USPS printouts, fax confirmations, email delivery receipts, and tracking numbers to validate timely appeal submission.
  • Monitor outstanding appeals and escalate unresolved cases in accordance with payer contract guidelines.
  • Track pending decisions and proactively follow up if no response is received within contractually defined timeframes.
  • Maintain detailed records of follow-up efforts, payer responses, and dispute outcomes.
  • Delivers excellent outcomes through collaborative teamwork, continuous improvement, and a client-first approach—while contributing to an engaging, positive team culture
  • Ability to accept and apply feedback to build proficiency in all responsibilities listed and adapt to changes in processes, priorities, and organizational needs.
  • Achieves all established departmental performance and production targets, ensuring work is completed accurately and meets departmental expectations for output and efficiency.
  • Other duties as required.

    • REQUIREMENTS AND QUALIFICATIONS

    • High School Diploma or GED required.  Associates or Bachelor’s Degree preferred.
    • 2-3 years’ experience in healthcare field working in billing or collections.
    • 1+ years’ customer services experience.
    • Knowledge of insurance payer/provider claims processing and subsequent data requirements.
    • Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
    • Strong interpersonal and communication skills, with the ability to collaborate effectively with team members and cross-functional teams.
    • Knowledge of the revenue cycle process.
    • Timely and regular attendance.
    • Equivalent combination of education and experience will be considered
    • 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 & PREREQUISITES

  • Practices and adheres to EnableComp’s Core Values, Vision and Mission.
  • This role is primarily office-based, depending on company policy, with extensive computer, phone, and document review work.
  • Ability to sit for extended periods while making calls and reviewing denial documentation.
  • Visual acuity to read and analyze medical records on screens and in printed formats.
  • Ability to meet benchmarks and handle time-sensitive workloads in a high-volume environment.
  • Proven written and verbal communication skills.
  • Strong analytical and problem-solving skills.
  • Ability to prioritize and manage multiple competing priorities and projects concurrently.
  • Expected to exercise sound judgment when escalating disputes or transferring cases.
  • Must be able to remain in stationary position 50% of the time.
  • If working onsite, may occasionally move about inside the office to access office equipment, etc.
  • Constantly operates a computer and other office equipment.



    • 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

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