This is a fully remote position, open to applicants in United States.

📋 Description

• Engage with insurance payers regarding outstanding claims.

• Identify barriers to payment and expedite cash collections.

• Follow up on and gather payments for assigned accounts.

• Leverage experience, follow-up techniques, and tools to resolve claims and secure payment.

• Elevate unpaid claims to payer claims supervisors when standard follow-up fails.

• Record client host-system activities using the 5 W’s framework along with relevant policies and procedures.

• Transfer account notes into Ovation’s workflow tool.

• Assign status codes, including root cause and action codes, within the Ovation workflow tool.

• Draft first- and second-level appeals for denials to ensure payment is received.

• Report payer denial trends and other issues to Management.

• Manage assigned underpayments as instructed by Management.

• Uphold daily productivity and quality standards.

• Investigate and analyze correspondence pertaining to assigned accounts.

⛳️ Requirements

• Ability to work independently from home in a dynamic, fast-paced, and goal-driven environment.

• Experience in direct account follow-up and/or billing.

• Preferred knowledge of Medical Terminology, ICD-10, CPT, and DRG.

• Intermediate proficiency in Excel is preferred.

• Comprehensive understanding of the entire revenue cycle.

• Detail-oriented and well-organized.

• Competency in applying critical thinking skills.

• Capability to assist with problem-solving, inquiries, and customer interactions.

• High school diploma or equivalent required.

• 3–5 years of experience in collections for hospital claims.

• Reliable internet connection and a quiet, dedicated workspace free from distractions.

• Access to required office equipment.

• Ability to communicate daily with team members, management, and clients via email, phone, video meetings, and collaborative tools.

🏝️ Benefits

• Opportunity for remote work from home.

• Requirements for stable internet connection, a quiet dedicated workspace, and necessary office equipment are provided.

• Daily communication through email, phone calls, video meetings, and collaborative tools.

• No travel is necessary.