Specialist, Accounts Receivable

QHR Health; United States; Remote; USD 41,000 - 61,000; Full time

Benefits offered by this job

Health and wellness benefits

HSA with employer contributions

Wellness program

Job summary

Ovation Healthcare is seeking a remote Claims Follow-Up Specialist to pursue payer payments and resolve obstacles to cash flow. You will follow up on accounts, escalate denials, and document activity in Amplify's workflow tool from a home office.

Requirements include 3–5 years of hospital collections experience, a high school diploma, knowledge of ICD-10, CPT and DRG, and basic Excel proficiency. This 100% remote role offers comprehensive benefits and a competitive compensation package.

Qualifications

• 3–5 years of hospital collections experience.
• High school diploma or equivalent required.
• Knowledge of ICD-10, CPT and DRG terminology and codes.
• Proficiency with Excel and basic data/documentation tools.

Responsibilities

• Follow up with payers on outstanding claims to collect payments.
• Escalate unresolved claims to supervisors as needed.
• Document activity in the client systems and Amplify workflow tool.
• Assign status codes to identify trends for improvements.
• Write appeals for denials and escalate as necessary.
• Handle underpayments as assigned and maintain daily productivity.
• Review correspondence and analyze accounts for accuracy.

Skills

Billing experience

Revenue cycle knowledge

Detail oriented

Independent from home

Excel proficiency

Education

High school diploma or equivalent

Tools

Amplify workflow tool

Excel

Job description

About the Job

Welcome to Ovation Healthcare! At Ovation Healthcare (formerly QHR Health), 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 www.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 collections experience in a Hospital Business Office

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

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
• Wellne