Specialist, Accounts Receivable

Summary

Ovation Healthcare supports independent community hospitals and health systems through healthcare services, guidance, and technology-enabled shared services. The Specialist, Accounts Receivable follows up with insurance payers on outstanding claims, resolves payment obstacles, manages denials and underpayments, and accelerates cash collections.

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

Skills

• 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
• 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
• High school diploma or equivalent
• 3-5 years of accounts receivables / collections experience
• 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
• Intermediate experience in Excel preferred
• Additional training in hospital insurance collections is a plus
• Meditech Expanse experience a plus

Qualifications

Must Haves

• 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
• 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
• High school diploma or equivalent
• 3-5 years of accounts receivables / collections experience
• 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

Nice to Haves

• Intermediate experience in Excel preferred
• additional training in hospital insurance collections is a plus
• Meditech Expanse experience a plus

Benefits

• 100% Remote
• Work from home and remote location