Ovation Healthcare

Compensation

Full Description

The primary responsibility of this position is to follow-up with insurance payers on outstanding claims, break down obstacles to payment, and accelerate cash collections. Duties & Responsibilities: Responsible for follow-up and collecting on accounts in assigned inventory. Utilizes experience and follow-up strategies and tools to resolve claims and obtain payment. Escalates unpaid claims to payer claims supervisor as appropriate when regular follow-up efforts are not successful. Documents client’s host system utilizing the 5 W’s framework and related policies/procedures to ensure accurate and complete documentation and then copies account notes into Amplify’s workflow tool Assigns appropriate status codes (e.g. root cause, action, etc.) in Amplify’s workflow tool so trends can be identified and addressed. Writes first and second level appeals of all denials in effort to overturn and secure payment. Escalates payer denial and other trends to Management for further assistance. May also work assigned underpayments as assigned by Management. Maintains client and/or position specific daily productivity and quality expectations. Researches and analyzes any correspondence received related to assigned accounts. Knowledge, Skills, and Abilities: Must adapt and demonstrate the ability to work independently from home in a fast-paced, changing and goal-oriented environment. Direct account follow-up and/or billing experience. Medical Terminology, ICD-10, CPT and DRG knowledge preferred Knowledge of third-party Insurance payer guidelines. Intermediate experience in Excel preferred. Provides information regarding patient accounts in response to inquiries, safeguarding confidential information in verbal replies and correspondence. Demonstrates understanding of the entire revenue cycle. Must be detail oriented, organized, and possess the ability to apply critical thinking skills. Assists with problem solving, inquiries, and customer interaction to ensure positive results. Work Experience, Education, and Certifications: High school diploma or equivalent; additional training in hospital insurance collections is a plus. 3-5 years of collections experience in a Hospital Business Office Working Conditions and Physical Requirements: Work from home and remote location with a stable internet connection, a quiet and dedicated workspace free of distractions, and access to necessary office equipment. The ability to have daily communication with team members, management, and clients through email, phone calls, video meetings and other collaborative tools. Primarily requires sitting at a desk for extended period. Proper lighting and ergonomics shole be maintained to reduce eye strain. Ovation will never contact applicants via Chatwork or any other messaging platform outside of our official channels. If you receive any communication claiming to be from Ovation through Chatwork or any unauthorized platform, please disregard it and report it to us immediately. Our official communication will always come from our company email domain or through recognized professional channels like LinkedIn. If you have any questions or concerns regarding the authenticity of a communication, please contact us directly at communications@ovationhc.com for verification. Headquartered in Brentwood, Tenn., Ovation Healthcare partners with 375+ hospitals and health systems across 47 states. For 45+ years, Ovation Healthcare has supported hospitals and health systems through a portfolio of shared services – Leadership Advisory, Spend Management, Revenue Cycle Management, and Technology Services– designed to provide scale and efficiency to hospital business operations.