Specialist, Follow Up

Ovation Healthcare

Mississauga

Remote

CAD 41,000 - 61,000

Full time

7 days ago

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Benefits offered by this job

Health benefits

HSA plan

Wellness platform

Employee assistance program

Paid time off

401(k) plan

Professional development

Company issued equipment

Job summary

Ovation Healthcare is seeking a remote Follow Up Specialist to manage electronic denials, paper denials, and unpaid claims across multiple insurers. You will forward denials, resolve aging accounts, and utilize portals, phone, and email to secure payment.

Ideal candidates have 1–2 years of AR follow-up experience, knowledge of CMS 1500 billing, and familiarity with multiple clearinghouses and EMRs. This is a 100% remote role with strong teamwork and professional growth opportunities.

Qualifications

Basic medical billing knowledge.
Basic health insurance carrier billing & reimbursement policies.
Problem solving & dispute resolution.
Ability to multitask and adapt to changing regulations.
Strong verbal and written communication skills.
Excellent organizational and time-management abilities.
Proficiency in using all Microsoft Office apps such as Teams, Outlook, and Excel.
Ability to handle multiple tasks and prioritize effectively.
High attention to detail and problem-solving skills.

Responsibilities

Follow up on denied and aging AR to resolve claims.
Direct denied claims to other departments when warranted.
Research denied claims via portals and payers.
Identify denial trends and report to lead for review.

Skills

Medical billing knowledge

Insurance billing policies

Problem solving

Multitasking

Verbal & written communication

Organization & time management

MS Office (Teams, Outlook, Excel)

Prioritization

Attention to detail

Tools

CMS 1500 Billing

Clearinghouses

Billing Systems

EMRs

Job description

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.

About The Job

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.

Welcome to Ovation Healthcare!

GENERAL SUMMARY:

Follow Up Specialist will work on electronic denial, paper denials and unpaid claims reports to resolve any claims that are denied or unpaid by all insurance carriers. The Specialist will be responsible for forwarding denials to other departments throughout the company so the claims can be handled properly. The Follow Up Specialist will utilize several resources to resolve unpaid claims by online portals, contact via telephone, corresponding via email and appealing claims when needed.

DUTIES AND RESPONSIBILITIES:

Denials:

Review denied claims for correction/resubmission.
Direct denied claims to other departments when warranted.
Utilize multiple online websites and portals for payers to research denied claims.
Identify denial trends and report to lead for review to assist in preventing future denials.

Aging AR Over 60:

Follow up on unpaid claims with insurance carriers after a specified claim age.
Contact insurance companies via telephone, portals, and email requests to inquire on claims denied in error or on claims where there is further information needed to resolve for payment.
Utilize multiple online websites and portals to research claims.
Identify denial trends and other issues with insurance carriers and report to lead for review to assist in preventing future denials.
Process appeals on denied claims.

KNOWLEDGE, SKILLS, AND ABILITIES:

Basic Medical Billing Knowledge.
Basic Health Insurance Carrier billing & reimbursement policies.
Problem solving & dispute resolution.
Ability to multitask and adapt to changing regulations.
Strong verbal and written communication skills.
Excellent organizational and time-management abilities.
Proficiency in using all Microsoft Office apps such as Teams, Outlook, and Excel.
Ability to handle multiple tasks and prioritize effectively.
High attention to detail and problem-solving skills.

WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS:

1-2 years' experience in an AR Follow-Up
Experience in Professional CMS 1500 Billing, Multiple Clearinghouses, Billing Systems, EMR’s
Knowledge of Multiple States Billing Requirements, Commercial and Government Payers

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

100% Remote
Expected to work from a designated home office or other quiet and secure location, free from distractions.
Access to a suitable workspace that includes reliable internet access.
Ability to sit for long periods while working at a desk or computer.
Regular use of a keyboard, mouse, and other computer peripherals.
Occasional video conferencing, which may involve sitting or standing for meetings.

TRAVEL REQUIREMENTS:

Benefits

The base compensation range for this position is:

$40,994.80 - $61,492.20

Compensation ranges could be hourly or salary depending upon the exempt status of the posted position.

Beginning compensation is determined based on objective factors such as location, qualifications, skills, certifications, and experience. Typically, a candidate is hired in the lower to midpoint of the range; the top end of the range is reserved for candidates with extensive specialized experience and mastery within the role. Compensation may increase over time based on performance, experience, and tenure.

Compensation is only part of Ovation's total compensation package. Some additional benefits offered to full-time associates are:

Comprehensive health and wellness benefits such as medical, dental, vision, life insurance, short and long-term disability coverage
HSA with employer contributions, flexible spending accounts for health care, and dependent care accounts
Wellness platform with premium incentives
Employee assistance support and additional voluntary supplemental plans including accident, critical illness, hospital indemnity, and child disability insurance
Robust and flexible paid time off offerings and company paid holidays
401(k) plan with discretionary employer match opportunities
Professional development opportunities
Company issued equipment