Specialist, ProFee Follow Up

Ovation Healthcare•Pawtucket, RI

7d•Remote

About The Position

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.

Requirements

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.
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

Responsibilities

Correct/Resubmit claims in the clearinghouse portal and in the billing system.
Direct rejected claims to other departments for resolution if warranted.
Identify denial trends and report to lead for review to assist in preventing future denials.
Open cases and work directly with the clearinghouse when claim rejections are being received in error.
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.
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.
Process appeals on denied claims.