Revenue Recovery Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 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

• Utilize the Health Innovas "Pulse" platform to review client accounts flagged for potential denials or underpayments • Investigate technical denials involving eligibility, registration errors, missing authorizations, and administrative issues • Analyze EOBs and compare actual payments against modeled payer contracts to identify and quantify contractual underpayments • Correct data errors and resubmit claims to resolve technical denials • Prepare documentation and justification for underpayment appeals and resolution efforts • Gather documentation for complex clinical and coding-related denials in collaboration with Clinical Appeals Specialists and Certified Coders • Diagnose denial and underpayment root causes and identify trends by payer, service line, and denial reason • Document actions, findings, and communications in the Pulse platform • Contribute to performance reports for internal leadership and clients • Work alongside Payer Contract Specialists and Denial Management leadership to resolve complex payment issues • Participate in ongoing training on the Pulse platform, payer rules, and denial trends

🎯 Requirements

• High School Diploma or equivalent required • Associate's or Bachelor's degree in a related field preferred • Minimum of 2+ years of experience in healthcare accounts receivable (AR), hospital billing, or revenue cycle resolution • Strong foundational understanding of the healthcare revenue cycle, including claims submission, remittance processing, and follow-up • Demonstrated analytical and critical thinking skills with a high level of attention to detail • Excellent written and verbal communication skills • Proficient with computers and technology, with an aptitude for quickly learning and mastering new software platforms • Prior experience specifically in denial analysis or underpayment identification • Familiarity with reading and interpreting payer contracts and fee schedules • Experience working within various payer portals and systems • Reliable high-speed internet connection • Stable Wi-Fi with sufficient bandwidth to support video conferencing, cloud-based tools, and other online work-related activities • HIPAA-compliant secure workspace free from unauthorized access or interruptions • No use of public Wi-Fi unless connected through a secure company-provided VPN • Compliance with applicable HIPAA privacy and security regulations

🏖️ Benefits

• 100% Remote • Reliable high-speed internet connection required for remote/hybrid positions • HIPAA-compliant work environment • Career development opportunity to become a subject matter expert • Ongoing training to master the Pulse platform and stay current on payer rules and denial trends • Collegial atmosphere of professionalism and teamwork • Opportunity to collaborate with highly skilled subject matter specialists and operations executives