Payments Specialist

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: 

The Payments Specialist is responsible for the manual and electronic posting of insurance and patient payments, as well as daily balancing and maintenance of team folders. Payments are received as 

Lockboxes, ACHs, Credit Cards and Over the Counter deposits. The Payments Specialists work to 

accurately meet all daily, weekly, and monthly goals including deposits. 

Duties & Responsibilities:  

• Posting Lockboxes and ACHs: 

  • Retrieve daily deposits in our document management system. 

  • Identify payment information and manually post to patient accounts (Lockboxes). 

  • Daily posting of the Electronic Remittance Advices, including all payments and adjustments needed 

• (ACHs). 

  • Any missing ERAs are designated as Pending to be located and applied to the correct accounts. 

• Identifying Denials: 

  • The poster finds denials and sends them on for further review 

• Posting Credit Card and Over the Counter Payments Daily Balancing: 

  • All Specialists balance daily deposits for each client, identifying any possible posting issues, and notifying the applicable personnel for corrections. 

• Payment Processing: 

  • Manage and process all incoming payments from patients, insurance companies, and third-party payers. Ensure payments are accurately recorded in the hospital’s financial system. 

• Billing Management: 

  • Oversee the preparation and submission of bills for hospital services to insurance companies and patients. Review billing codes, medical records, and other documentation for accuracy before submission. 

• Insurance Claims: 

  • Submit insurance claims, track their status, and follow up on unpaid claims. Ensure all claims are submitted in compliance with insurance company guidelines and government regulations. 

• Payment Reconciliation: 

  • Reconcile patient accounts, insurance payments, and other financial transactions. Ensure accurate balancing of accounts and resolve discrepancies as needed. 

• Patient Communication: 

  •  Communicate with patients regarding outstanding balances, payment plans, and billing inquiries. 

  • Assist patients in understanding their insurance coverage and hospital charges. 

• Financial Reporting: 

  • Assist in the preparation of financial reports related to payments, billing, and accounts receivable. 

  • Provide detailed information to department heads and hospital leadership as needed. 

• Compliance & Regulations: 

  • Ensure all payment processing activities are in compliance with healthcare laws, regulations, and hospital policies. Stay informed on changes in billing codes, insurance requirements, and government regulations. 

• Customer Service: 

  • Provide exceptional customer service to patients, family members, and insurance providers. 

  • Address inquiries regarding billing discrepancies, payment plans, and account statuses. 

• Data Entry & Recordkeeping: 

  •  Accurately enter payment information into the hospital’s financial software system. Maintain organized records of payments, invoices, claims, and communications. 

• Collaborate with Other Departments: 

  • Work closely with other departments, such as the revenue cycle team, finance, and patient services, to ensure smooth operations and efficient payment processing. 

   

Knowledge, Skills, and Abilities:  

• Posters will learn to read EOBs and ERAs to accurately post payments to patient accounts. 

  • This requires both accuracy and speed to attain all departmental goals. 

• Strong understanding of medical billing codes (CPT, ICD-10, HCPCS). 

• Familiarity with insurance policies, payment processes, and healthcare billing regulations. 

• Proficiency in financial software and Microsoft Office Suite (Excel, Word, etc.). 

• Excellent attention to detail and organizational skills. 

• Strong communication skills, both verbal and written. 

• Ability to handle sensitive information confidentially and with professionalism. 

Work Experience, Education and Certifications:  

• HS Diploma or GED required. 

• 2-3 years of experience in healthcare billing, insurance claims processing, or payments management, preferably in a hospital or healthcare setting. 

Working Conditions and Physical Requirements:  

• 100% Remote 

• Expected to work from a designated home office or other quiet and secure location, free from 

• distractions. 

• Access to a suitable workspace that includes reliable internet access. 

• Ability to sit for long periods while working at a desk or computer. 

• Regular use of a keyboard, mouse, and other computer peripherals. 

• Occasional video conferencing, which may involve sitting or standing for meetings.