Teams at Ovation Healthcare

Manage daily hospital billing operations, including preparing clean UB-04 and 1500 claims, resolving claim edits, submitting payer appeals, reconciling payments, processing remittance advice, and addressing outstanding balances. Ensure compliance with CMS, HIPAA, payer policies, and company standards while maintaining accurate patient account records. Collaborate with financial services and billing teams, meet productivity targets, and support efforts to reduce accounts receivable days.

Follows up with insurance payers on outstanding hospital claims, resolves payment obstacles, writes appeals for denials, researches account correspondence, documents claim activity, assigns workflow status codes, and supports underpayment recovery. The role requires meeting productivity and quality goals while safeguarding confidential patient account information and working independently in a fully remote environment.

Investigates and resolves technical claim denials and contractual underpayments for hospital clients. Reviews accounts, EOBs, payer contracts, and fee schedules; corrects errors, resubmits claims, prepares appeals, and collaborates with clinical appeals and coding specialists. Documents findings in the Pulse platform, identifies denial trends and root causes, supports reporting, and helps prevent future revenue leakage.