跟进专员
Specialist, Follow Up
欢迎来到Ovation Healthcare！
在Ovation Healthcare，我们已经为本地医疗保健带来了40多年的变化。我们的使命是加强独立社区医疗。我们为独立医院和医疗系统提供支持、指导和技术驱动的共享服务，以保持其强大和可持续性。凭借强烈的目标感和对卓越运营的承诺，我们帮助农村医疗机构实现他们的使命。
Ovation Healthcare的独特之处在于将运营经验与咨询服务相结合，以实现我们为医疗保健机构创造可持续未来的使命。Ovation Healthcare的愿景是成为一家动态、整合的专业服务公司，通过经验与思想领导力提供创新且可执行的解决方案，同时重视信任、尊重和以客户为中心的行为。
我们正在寻找有才华、有动力的专业人士，他们希望帮助独立医院蓬勃发展。在Ovation Healthcare工作，您将有机会与高技能的专家和运营高管合作，在专业和团队合作的氛围中工作。
Ovation Healthcare的总部位于田纳西州Brentwood。如需更多信息，请访问。
简介：
跟进专员将处理电子拒付、纸质拒付和未付款索赔报告，以解决所有保险公司拒付或未付款的索赔。该专员负责将拒付信息转发到公司其他部门，以便妥善处理索赔。跟进专员将利用多个资源通过在线门户、电话联系、电子邮件沟通以及必要时申诉来解决未付款索赔。
职责和责任：
- 电子拒付：
- 在清算中心门户和计费系统中更正/重新提交索赔。
- 如果需要，将被拒绝的索赔转至其他部门进行处理。
- 识别拒付趋势，并向主管报告以协助防止未来的拒付。
- 当收到错误的索赔拒绝时，开设案件并直接与清算中心合作。
- 拒付：
- 审核被拒的索赔以进行更正/重新提交。
- 如果需要，将被拒的索赔转至其他部门。
- 利用多个在线网站和保险公司门户来研究被拒的索赔。
- 识别拒付趋势，并向主管报告以进行后续处理。
查看英文原文
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.
Summary:
Follow Up Specialist will work on electronic denial, paper denials and unpaid claims reports to resolve anyclaims that are denied or unpaid by all insurance carriers. The Specialist will be responsible for forwardingdenials to other departments throughout the company so the claims can be handled properly. The FollowUp Specialist will utilize several resources to resolve unpaid claims by online portals, contact viatelephone, corresponding via email and appealing claims when needed.
DUTIES AND RESPONSIBILITIES:
- Electronic Denials:
- 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 inerror.
- 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 claimdenied 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 toassist 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
- Reliable high-speed internet connection is required for all remote/hybrid positions.
- Must have access to stable Wi-Fi with sufficient bandwidth to support video conferencing, cloud-based tools, and other online work-related activities.
- A HIPAA-compliant work environment is required, including a secure workspace free from unauthorized access or interruptions, no use of public Wi-Fi unless connected through a secure company-provided VPN, and compliance with all applicable HIPAA privacy and security regulations.
- Expected to work from a designated home office or other quiet and secure location, free fromdistractions.
- 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:
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Originally posted on Himalayas