Billing Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Billing Specialist

👻 Ghost score 11%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Ovation Healthcare

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 45 years

💼 Consulting

📦 Logistics

🏭 Manufacturing

Consulting • Logistics • Manufacturing

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.

📋 Description

• Manage daily billing and ensure timely, accurate, clean claims • Review claims and resolve daily claim edits while ensuring compliance with insurance billing policies and regulations • Maintain split billing requirements by payer and update the team crosswalk for payer changes • Upload appeals through payer portals and provide feedback to the internal team • Import claims from the host system into the claims processing system when required • Prepare and submit accurate claims for patient services in compliance with third-party payer guidelines and regulations • Review patient accounts, reconcile payments with secondary payers, and process remittance advice • Ensure payments are posted correctly and outstanding balances are addressed before secondary payer filing • Maintain compliance with CMS regulations, HIPAA, and company policies • Maintain accurate claims records and proper documentation in the patient account system • Meet assigned daily productivity and quality standards • Collaborate with patient financial services, finance, and billing departments to address patient-account issues and disputes • Assist management in maintaining or reducing accounts receivable days and improving organizational cash flow

🎯 Requirements

• Proven experience in third party insurance billing, collections, or patient accounts, preferably in a healthcare setting • In-depth knowledge of billing codes, guidelines, and regulations • Familiarity with electronic health record (EHR) systems, billing software, and remittance advice processing • Strong communication skills, including explaining Medicare billing details and resolving patient concerns • Ability to handle sensitive information and maintain confidentiality in accordance with HIPAA regulations • Detail-oriented with strong organizational skills and ability to manage multiple accounts simultaneously • Problem-solving abilities regarding billing discrepancies and denied claims • Experience utilizing payer portals, client systems, and clearing house requirements • 3–5 years of experience as a primary biller in a hospital business office • Knowledge of medical terminology, ICD-10, CPT, DRG, and third-party insurance payer guidelines • High school diploma or equivalent • Previous experience with California payers preferred

🏖️ Benefits

• Work from home and remote location • Stable internet connection, quiet and dedicated workspace, and necessary office equipment • Daily communication through email, phone calls, video meetings, and collaborative tools • No travel required