What are the responsibilities and job description for the Specialist, EDI Enrollments position at Ovation Healthcare?
Welcome to Ovation Healthcare!
At Ovation Healthcare (formerly QHR Health), 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
www.ovationhc.com
.Summary:
As an Specialist, ERA/EFT Enrollments, your role is to maintain an automated process for receiving payments and Explanation of Benefits from the payers and ensuring that all payers have the current billing and payment information on file. During this process we also ensure that we receive any EOB’s necessary to process payments received.
Duties & Responsibilities:
- ERA and EFT Enrollments
- Review all payments being received to identify all payers that EDI, ERA and EFT can be processed through our clearinghouse, create the enrollments, and follow up on approval of enrollments.
- Communicate with our clearinghouse on any enrollment issues.
- Billing and Payment Maintenance
- Maintain all billing and payment information for payers by reviewing all data and documents received from payers and identify any updates that need to be made.
- We process any updates that we identify by completing the payer’s instruction for updating the information and follow up on the completion.
- EOB Retrieval
- Support the payments department by contacting any payer to obtain copies of EOB’s that we have not received.
- Any payments identified needing additional information or copy of EOB we contact the payer to have reprocessed to us.
Work Experience, Education and Certifications:
- High school diploma or equivalent; an associate’s degree in healthcare administration or related field is a plus.
- 1-2 years of experience in a healthcare related role
Working Conditions and Physical Requirements:
- Remote – work from home
Travel Requirements:
- No Travel