Specialist, Accounts Receivable

Job summary

The role focuses on following up with insurance payers on outstanding claims to accelerate cash collections and resolve payment obstacles. Responsibilities include writing appeals for denials, documenting account notes, and analyzing payer trends.

Job details

Welcome to Ovation Healthcare! At Ovation Healthcare, we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. We’re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. Ovation Healthcare's corporate headquarters is located in Brentwood, TN. For more information, visit https://ovationhc.com. Summary: 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 and 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 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 insurance accounts receivable follow up. Previous experience with California payers preferred. Working Conditions: 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. 100% Remote

What you’ll do

The role focuses on following up with insurance payers on outstanding claims to accelerate cash collections and resolve payment obstacles. Responsibilities include writing appeals for denials, documenting account notes, and analyzing payer trends.

Requirements

Candidates need 3-5 years of insurance accounts receivable experience and a high school diploma or equivalent. Knowledge of medical terminology, ICD-10, CPT, and DRG is required, with a preference for experience with California payers.

Listed skills

• Microsoft Excel · Preferred
• Accounts receivable · Preferred
• Critical Thinking · Preferred

Other relevant skills

Identified from the job description. Confirm important requirements above.

• Accounts Receivable
• Insurance Follow-up
• Medical Billing
• Medical Terminology
• ICD-10
• CPT
• DRG
• Excel
• Revenue Cycle Management
• Claims Resolution
• Denial Management
• Critical Thinking

Job areas

• Finance & Accounting
• Healthcare
• Consulting
• Administrative