Ovation Healthcare

• Lead all back-end revenue cycle functions (billing, collections, denials, and revenue integrity across the hospital). • Drive modernization of billing platforms and front-end digital tools. • Implement dashboards and performance tracking systems for KPIs. • Centralize revenue cycle functions into a high-performing CBO model. • Serve as a key partner to the CFO and executive team in revenue cycle strategy.

• Extract, compile, and validate data from multiple sources including EHRs and ERP systems. • Develop and maintain data pipelines and queries to ensure reliable and consistent data feeds. • Analyze hospital financial and operational data to identify trends, variances, and performance drivers. • Support monthly close processes, budgeting, forecasting, and variance analysis. • Design, develop, and maintain standardized and ad hoc reports using SQL and other reporting tools. • Partner with accounting, revenue cycle, and operations teams to understand reporting needs.

• Consult with client and Operations Team to understand their business objectives • Design and facilitate know solutions, plan projects, and guidance throughout the implementation • Leverage industry knowledge and application expertise in the implementation of CPSI/TruBridge software solution • Demonstrate product and industry knowledge in Hospital and Clinic Revenue Cycle operations • Ensure ongoing positive interactions and professional rapport with clients throughout the project lifecycle • Serve as a client-facing consultant, providing expert guidance and support throughout the implementation and post go live process • Provide configuration guidance, application training, and support to clients, ensuring they are fully enabled to utilize the new platform effectively • Partner closely with Project Manager to identify potential risks and develop mitigation strategies to ensure successful project outcomes • Continuously monitor and report on project progress, addressing any issues or concerns promptly • Routinely provide feedback to cross functional stakeholders regarding client feedback, product feedback and other issues related to the implementation • Be accountable for and meet deadlines, including adhering to the project timeline, assigning internal/external tasks, and following up on assignments to drive completion • Drive innovation by communicating with team members regarding new ideas pertaining to the project

• Payment posting manual/Electronic (ERA’s) patient and insurance payments, adjustments, and/or denials • Locate remittances & payments in various portals &/or clearinghouse • Read and interpret EOB’s • Apply copay/coinsurance and deductible balances to patient responsibility • Review of patient account balances as needed to determine posting accuracy • Perform payment deposit downloads and bank reconciliations • Daily cash reconciliation and reporting • Research and resolve unapplied accounts • Flexibility to cross train/assist with training/cover for other team members and/or with other projects as needed • Identify and report on trends/issues • Prepare, reconcile and complete the local bank deposits for mail patient/insurance/accounting payments & other hospital/clinic departments (does not apply to home-based candidates) • Maintain/reconcile petty cash funds, process point of service patient payments (does not apply to home-based candidates) • Post monthly agency payment reports • Work to resolve unidentified deposits • Work posting issue work queues

• Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse • Creates appropriate letters to substantiate the validity of claims • Meets with facility liaison to review documentation, resolve coding, and tagging files for follow-up • Investigates and problem-solves reimbursement issues in collaboration with other coding staff and faculty • Works directly with facility liaison or other clinical staff as needed to provide documentation feedback and to develop appeals • Researches payer policies and processes • Reviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment • Works assigned work queues and tasks and reviews remittance advice for rejections and accuracy of payment amounts as needed • Identifies invoices or claims that have been rejected per billing edits/criteria

• Responsible for reviewing medical records for outpatient, or same day, surgical procedures, and assigning appropriate diagnostic and procedural codes (CPT and ICD-10) to ensure accurate billing and reimbursement. • Apply appropriate coding classification standards and guidelines to medical record documentation for accurate coding. • Submit necessary provider queries to resolve documentation discrepancies. • Perform quality assessment of records, including verification of medical record documentation. • Review appropriate charges and make changes or recommendations based on the documentation. • Responsible for researching errors or missing documentation from medical records to provide accurate coding processes. • Abstracts and assigns the appropriate ICD-10-CM and CPT codes for all diagnoses and procedures performed in the outpatient and surgical settings as applicable.

• Manage ServiceNow instance health, upgrades, and patches. • Configure and maintain ServiceNow modules (ITSM, ITOM, SPM, ITAM, SecOps, etc.). • Monitor performance and troubleshoot issues to ensure platform stability. • Create and manage user roles, groups, and permissions. • Ensure compliance with security and governance policies. • Implement advanced UI policies, business rules, workflows, and notifications. • Lead integrations with third-party systems and APIs. • Identify opportunities for automation and process optimization. • Maintain documentation for configurations, processes, and procedures. • Develop and maintain dashboards and reports for stakeholders. • Provide mentorship and guidance to junior administrators.

• Performs hands-on vulnerability remediation, patch deployment, and secure configuration hardening for Windows Server environments. • Ensures remediation is executed within formal change control. • Review Qualys Vulnerability Management findings for Windows servers and define remediation plans. • Test and deploy patches using Microsoft System Center Configuration Manager or Microsoft Endpoint Configuration Manager. • Create new Software Update Groups each month for workstations and servers. • Schedule and configure deployments for new Software Update Groups. • Implement Windows Server hardening baselines including security configuration standards. • Validate remediation closure through health checks and Qualys rescans. • Troubleshoot patch failures and service impacts; support restoration and root cause analysis. • Maintain operational metrics for patch compliance and vulnerability aging.

• Responsible for coding and abstracting of diagnoses from medical records • Assigns ICD-10-CM codes for medical record accounts • Reviews records for clinical pertinence and documentation • Communicates with providers for clarification • Reviews and resolves claim edits related to outpatient encounters

• Process vendor invoices, ensuring accuracy and proper matching to purchase orders and receiving documents • Prepare and issue payments in accordance with established policies and timelines • Perform billing, payment, and collections activities as assigned • Reconcile accounts and investigate discrepancies in a timely manner • Reconcile daily cash receipts and deposits, with supporting documentation • Assist with bank reconciliations and resolve discrepancies • Monitor and escalate discrepancies as appropriate • Prepare and enter journal entries and assist with month‑end closing procedures • Maintain accurate and organized financial records • Assist with account reconciliations, variance research, and audit requests • Assist with payroll process as assigned based on client needs • Prepare reports, spreadsheets, and data summaries for leadership