Client Operations Insurance Specialist

Job not on LinkedIn

November 18

🎸 Tennessee – Remote

Although this job is listed in Tennessee, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

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Ovation Healthcare

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Healthcare Insurance • SaaS • Education

Ovation Healthcare is a leading provider of shared services for independent hospitals and health systems. With over 45 years of experience, the company enhances hospital and system performance through services like leadership advisory, supply chain management, revenue cycle management, technology services, and clinical care management. Ovation Healthcare is dedicated to supporting the financial and clinical needs of hospitals while preserving their focus on patient care and community wellness. Their educational programs and consulting services aim to strengthen hospital operations, making healthcare delivery more efficient and effective.

201 - 500 employees

Founded 45 years

⚕️ Healthcare Insurance

☁️ SaaS

📚 Education

📋 Description

• Process and manage insurance claims for patient accounts • Follow up on unpaid claims and outstanding balances • Manage all open agent tickets relating to insurance inquiries through completion • Post any missing payments to accounts through RP function for client reconciliation process • Provide feedback to Management on any issues concerning call center behavior as it relates to agent tickets • Provide feedback to Management on any client issues in time for scheduled client meetings • Take initiative and action to respond, resolve and follow up regarding customer service issues and client requests in a timely manner • Ensure all accounts have been billed in HOST system by designed payer requirement dates for prompt payment • Meet all out of guideline requirements set forth by department leadership

🎯 Requirements

• Experience with various non-government insurances • Experience with claim edits • Denials and insurance follow up • Efficient in Microsoft Office products, especially Excel and Word • Knowledge and understanding of diagnosis, HCPCS and CPT codes • In-depth understanding of remittance advice, electronic billing reports, and claims resolution • Extensive knowledge of medical billing, insurance processes, managed care, and payer guidelines • Understanding of legal rules and regulations pertaining to billing, collections, and HIPAA • Ability to work independently while also contributing to team success and organizational goals

🏖️ Benefits

• Health insurance • 401(k) matching • Paid time off • Flexible work arrangements