Endodontist

Director, Out of State Medicaid (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, OSM is a key leader within the Out-of-State Medicaid function responsible for driving performance, operational execution, and client outcomes across multiple teams. This role oversees Managers, Supervisors, and Revenue Specialists, ensuring alignment of day-to-day operations with departmental strategy, revenue targets, and client expectations. The Director is accountable for setting priorities, optimizing resource allocation, and delivering consistent, high-quality results through effective leadership, performance management, and cross-functional collaboration. In partnership with senior leadership, this role identifies opportunities for continuous improvement, enhances operational efficiency, and develops leadership capability within their span of control to support sustained performance and growth. JOB RESPONSIBILITIES • Ensure the processes and inventory are in place to hit monthly, quarterly, and annual revenue expectations for the company. • Lead multiple teams through Managers and Supervisors by establishing daily, monthly, and strategic goals, ensuring alignment to revenue targets and operational priorities. • Oversee hiring, onboarding, and performance management across assigned teams, ensuring strong leadership capability and team effectiveness. • Oversee performance management processes, including goal setting, performance reviews, and accountability frameworks across Managers and Supervisors. • Oversee workload distribution and capacity planning across teams to ensure efficient execution and alignment with business priorities. • Perform regular audits and client reviews ensuring EC is delivering all requirements to the satisfaction of the client. • Measures and monitors key performance metrics and delivers concise performance reporting to stakeholders with corrective action plans for variances when appropriate. • Assists in setting the strategic direction of the Out-of-State Medicaid team and identifies areas of continuous improvement in conjunction with the leadership team. • Maintain a strong knowledge of insurance billing and reimbursement procedures and regulations. • Researches and analyzes collections systems processes in Enforcer, including process improvement and SOP enhancement recommendations. • Coordinate cross-functional resources to execute action plans for assigned accounts and resolve operational challenges impacting performance. • Oversee the implementation and adherence to quality and productivity standards across teams, ensuring consistency and accountability. • Set and adjust priorities across teams to ensure optimal resource allocation and focus on the most impactful and profitable work. • Ensure compliance with HIPAA and related regulatory requirements through oversight of processes, policies, and team adherence. • Hold Managers and Supervisors accountable for team performance, including productivity, quality, and adherence to workflows and service level expectations. • Develop and strengthen leadership capability by coaching Managers and Supervisors, building a pipeline of future leaders. • Provide guidance and oversight on complex performance management matters, ensuring consistent application of expectations and company policies. • Support operational and business transformation initiatives, ensuring adoption and execution across teams. • Maximize efficiency and productivity through extensive process analysis and interdepartmental collaboration. • Assist with audits and client reviews ensuring EC is delivering all requirements to the satisfaction of the client. • Other duties as required REQUIREMENTS AND QUALIFICATIONS • Bachelor's degree in business or healthcare administration preferred. High School Diploma or GED required. • 7-10 years' experience in management or supervisory experience with team size of 10+. • 6+ years' experience in healthcare setting, information technology company or managed care industry, preferably in the area of Finance/Collections, Business Operations or Revenue Recovery. • Experience working with internal teams while serving in a client facing or client support role. • Knowledge and understanding of financials, HMO's, hospital revenue cycle process, ancillary and provider contract language and familiarity with healthcare and provider data sets. • Extensive level of understanding of insurance payer/provider claim 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). • 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 • Strong and professional written and oral communications skills. • Has worked in a production environment and can meet deadlines. • Excellent people skills to interface with multiple internal stakeholders. • Demonstrated ability to successfully work collaboratively within a team and cross-functionally. • Proven success in obtaining quantifiable results from and setting priorities for direct reports. • Organized and can handle multiple projects simultaneously. • Ability to set and manage multiple priorities among several teams. • Experience communicating obstacles & challenges and developing action plans to present to management. 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

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

Hiring in Franklin, TN Warning: You're going to want to click “APPLY” before you finish reading. This is for closers. Period. Chuck McDowell's Wesley Financial Group, the leader in timeshare cancellation, is on a mission to find top-tier sales talent with the drive (and skill) to earn serious money, feel good about what they do, and never worry about cold calling or prospecting again. Picture this: • Warm, pre-set appointments dropped directly onto your calendar • A 2020 INC 500 company offering base pay + commissions + 401k match + health benefits • A culture that values its salespeople and invests in them with coaching, support, and real opportunity for growth No Cold Calling. No Prospecting. Ever. Sound too good to be true? It isn't. We're looking for the top 5%, people who hate average. Our top 20% made $259,209 – $286,060 last year. (By the way, the “average” rep here still clocked in at $232,192 last year.) If you're driven, organized, and refuse to be average, keep reading. If not, this isn't the job for you. Job Summary: You will be responsible for calling preset scheduled sales appointments of timeshare owners who have requested help in canceling their timeshare with Wesley Financial Group, LLC, and onboarding them as clients. This includes pricing our services, sending and reviewing our agreement, and getting the client set up for onboarding. IMPORTANT: Every appointment is pre-qualified by our Qualification Specialists and placed directly on your calendar. Our fully staffed marketing team provides leads (currently more than 3,000/week) to ensure a constant flow of new appointments. This is a closing job ONLY. No cold calling. No prospecting. 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 appointments in an efficient and timely manner • Ask questions to understand the prospect's situation with their timeshare and onboard them for our services • Explain the value and process of working with Wesley Financial Group, LLC • Input client information into Salesforce Requirements: • Computer skills (Google Suite/Microsoft Office preferred) • 2-3 years of sales experience (timeshare or phone sales preferred) • Salesforce experience is a plus • Excellent communication skills (verbal and written) • Ability to work independently in a fast-paced environment • Must successfully pass the assessments after completion of training Compensation: • Base pay • Uncapped commission • 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: Franklin TN: Hybrid • Friday - Monday 9am - 7pm | Friday - Sunday WFH | Monday Onsite In Office 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: • 2024 Great Place to Work Certified • 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 • Fun engaging company-wide events and activities • Generous PTO plus 9 paid holidays and 2 floating holidays • Outstanding 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. Friday - Monday 9am - 7pm | Friday - Sunday WFH | Monday Onsite In Office - MUST LIVE WITHIN 60 MILES OF FRANKLIN, TN OFFICE Compensation details: 259209-286060 Yearly Salary PI12c133f56e00-31181-39689246

DRG Auditor (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 DRG Auditor is responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities based on diagnosis and procedure coding. Working within a specialized DRG (Diagnosis-Related Group) database, DRG Reviewers utilize their technical expertise in ICD-10 coding to analyze medical records, determine coding accuracy, and make recommendations that optimize hospital reimbursement. This role requires certification as a Certified Coding Specialist (CCS) and a deep understanding of medical record documentation, clinical coding guidelines, and DRG reimbursement methodology. 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 inpatient claims imported into the DRG database, focusing on diagnosis, procedures, grouping logic, and reimbursement accuracy. • Analyze weekly hospital billing files, identifying underpaid claims based on ICD-10 diagnosis and procedure codes. • Conduct detailed medical record reviews post-bill to determine if submitted diagnosis and procedure codes are accurate and complete. • Navigate medical records efficiently, targeting specific sections (e.g., discharge summary, operative reports) based on system edits and flagged items. • Match clinical documentation in the medical record to corresponding ICD-10 codes, ensuring DRG accuracy. • Identify and correct errors such as under coded or misclassified diagnoses and procedures. • Utilize Health ROI system edits to detect specific high-value opportunities (e.g., dialysis, occlusion, embolization, catheterization). • Make reimbursement improvement recommendations and submit findings for client review and approval. • Collaborate with leadership on case prioritization and workflow management. • Stay informed on coding updates, payer guidelines, and DRG changes to support accurate recommendations. • Analyze client reporting. • Identify new revenue opportunities related to all inpatient DRG related components. • Other duties as required. Requirements and Qualifications • Associate's or bachelor's degree in health information management or related field required. (RHIT or RHIA credentialed individuals encouraged). • Certified Coding Specialist (CCS) certification required. • 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review. • Strong understanding of ICD-10-CM/PCS coding guidelines, DRG reimbursement methodology, and hospital billing processes. • Proficient in reading and interpreting clinical documentation across multiple departments (e.g., nursing, operative, radiology, pharmacy). • Experience working in a post-bill coding environment and familiarity with DRG grouping software and billing databases. • Analytical thinker with a focus on financial impact and reimbursement accuracy. • Comfortable navigating multiple digital platforms, EMRs, and data systems. • 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. Special Considerations and Prerequisites • This role is primarily office-based or remote, depending on company policy, with extensive computer and document review work. • Must be comfortable working independently in a detail-oriented, data-driven environment. • Excellent communication and documentation skills to support client reporting and recommendations. • High integrity and professionalism in handling PHI and confidential information. • Strong collaboration and responsiveness to feedback from leadership and client partners. • Ability to review and analyze large volumes of medical and billing data. • Strong focus and attention to detail in identifying discrepancies and ensuring compliance. • Ability to manage high volumes of case processing with accuracy and efficiency. • Ability to meet deadlines 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. • Proven experience working with external clients; strong customer service skills and business acumen. • Timely and regular attendance. 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