Jobs at Ovation Healthcare

Leads strategic and operational execution across Sales, Implementation, Client Success, and internal teams. Translates priorities into plans, manages complex client projects and implementations, coordinates cross-functional stakeholders, tracks risks and milestones, supports executive decision-making, and drives scalable process improvements. Builds relationships with hospital and health system leaders while influencing accountability and results without direct authority.

Design, build, and maintain scalable data pipelines, data models, and analytics solutions using Microsoft Fabric and Azure. Develop Lakehouse and Warehouse architectures, Fabric Notebooks with PySpark and Spark SQL, ETL/ELT workflows, and Power BI semantic models. Optimize performance, ensure data quality, security, governance, and regulatory compliance, and collaborate with analysts, data scientists, and business stakeholders to support business intelligence and advanced analytics.

Resolves electronic and paper denials, rejected claims, and unpaid accounts receivable claims. Corrects and resubmits claims, researches payer portals, contacts insurance carriers, directs cases to appropriate departments, identifies denial trends, and processes appeals. Requires medical billing and reimbursement knowledge, familiarity with CMS 1500 billing, clearinghouses, billing systems, EMRs, and multistate payer requirements. This is a fully remote role with 0% travel.

Follows up with insurance payers on outstanding claims, resolves payment barriers, accelerates collections, and writes appeals for denied claims. Documents account activity, assigns workflow status codes, researches correspondence, escalates payer issues, and may handle underpayments. The role requires revenue cycle knowledge, medical coding familiarity, attention to detail, productivity, confidentiality, and independent remote work.

Manages hospital accounts receivable operations, including billing, collections, reimbursement, denial resolution, payer follow-up, and revenue cycle performance. Leads and trains A/R staff, monitors productivity and collection metrics, reviews patient accounts for accuracy, prepares reports, ensures regulatory and payer compliance, and implements process improvements to increase cash flow. The role also handles staffing, performance management, client communications, and healthcare business office operations while traveling extensively to client sites.

Manages daily healthcare billing operations, including preparing clean UB-04 and CMS-1500 claims, resolving claim edits, handling payer appeals, reconciling payments, and addressing outstanding balances. Ensures compliance with payer requirements, CMS regulations, HIPAA, and company policies. Maintains accurate patient account documentation, collaborates with finance and patient financial services, and supports accounts receivable performance and cash flow improvements.

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.