Resolution Analyst, Denials

About the Company

EnableComp delivers specialty revenue cycle management services for healthcare organizations. With more than 24 years of experience, the company uses its E360 RCM intelligent automation platform, proprietary algorithms, and human expertise to support hospitals, health systems, and ambulatory surgery centers across the country. Its work spans Veterans Administration, Workers’ Compensation, Motor Vehicle Accident, Out-of-State Medicaid, and denial management for all payer categories. The company is recognized for strong growth, a workplace award history, and national industry rankings.

Role Overview

The Resolution Analyst serves as the connection point between client stakeholders and the denial and underpayment appeal workflow. The role focuses on recovering payments on denied and underpaid accounts for assigned clients to help improve revenue performance. Because the position involves patient health information, it requires strict attention to confidentiality, privacy, and security of sensitive data.

Key Responsibilities

• Analyze denied, underpaid, outstanding, and other assigned claims using EnableComp’s internal software, systems, and tools.
• Apply payer payment records and provider contract terms to confirm the correct reimbursement amount.
• Examine hospital contracts to detect and recover payments owed by insurers on delayed, denied, or underpaid claims.
• Gather medical records and supporting documents needed to prepare and submit detailed underpayment appeals to the right payer.
• Make prompt and complete follow-up calls with payers to verify receipt of documentation and advance claim resolution.
• Support smoother operations and contribute to better client satisfaction.
• Carry out additional duties as needed.

Requirements and Qualifications

• High school diploma or GED is required; an associate degree or bachelor’s degree is preferred.
• At least 5 years of experience in healthcare billing or collections is required.
• At least 1 year of client-facing or customer service experience is required.
• Working knowledge of payer and provider claims processing and related data requirements.
• Strong computer skills, including the ability to use Microsoft Word, Excel, and Outlook.
• Intermediate familiarity with ICD, HCPCS/CPT coding, and medical terminology.
• Solid understanding of the revenue cycle process.
• Good grasp of hospital reimbursement, managed care contract concepts, contract language, and federal and state requirements.
• Knowledge of HMO, PPO, IPA, and capitation claim-processing terms.
• Working understanding of EOBs, UB-04 billing requirements, and HCFA 1500 forms.
• Ability to review payer and client contracts to uncover complex underpayments.
• Consistent and reliable attendance is required.
• Must be able to perform the essential duties of the role, with reasonable accommodation available for qualified individuals with disabilities.

Special Considerations and Prerequisites

• Alignment with EnableComp’s core values, vision, and mission is expected.
• Demonstrated history of meeting or exceeding productivity goals.
• Ability to stay composed under pressure and maintain effective working relationships.
• Self-directed work style with the ability to function independently without close supervision.
• Strong written and verbal communication skills.
• Well-developed analytical and problem-solving ability.
• Proven experience working with external clients, along with strong customer service and business judgment.
• Ability to organize, prioritize, and manage several competing tasks and projects at once.
• Must be able to remain stationary about half the time.
• May occasionally move within the office to access equipment and related resources.
• Frequent use of a computer and office equipment such as a copier, scanner, printer, and phone.

Equal Opportunity and Hiring Process Notice

EnableComp is an equal opportunity employer (M/F/D/V). All candidates are evaluated based on experience and knowledge without regard to race, color, religion, national origin, sexual orientation, ancestry, marital status, disability, or veteran status. The company states that it is committed to a workplace free from discrimination and harassment.

The company also notes that it uses AI tools to help with parts of recruitment, such as reviewing applications, analyzing resumes, and checking responses for possible inconsistencies or verification signals. These tools support the recruiting team but do not replace human judgment, and final hiring decisions are made by people. Candidates can contact the company for more information about data processing.

Company Culture

EnableComp emphasizes employee growth, professional development, and a supportive workplace culture. It describes itself as an employer that invests in tools, resources, and support to help employees succeed. Employee testimonials highlight shared goals, teamwork, flexibility, work-life balance, and a people-first environment.