Escalation Specialist

ID 2025-5245
Location/Org Data : Name Linked
Remote Nationwide U.S.A.
Location Status
Remote
Segment
Sound Physicians Segment
Work Shift Time Zone
Eastern Time

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

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    • As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards.

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Job Summary

  • The Escalation Specialist is responsible for responding to and handling complaints and escalations from patients and clients as it relates to account balances and payments. They must seek ways to determine appropriate courses of action, conduct investigative steps to resolve issues, and communicate with their manager promptly for updates and resolution of such escalations. They are also responsible for completing special projects for escalated clients per the advisory of their manager and must maintain the deadline provided for given projects. The Escalation Specialist will be expected to perform all payment posting activities within the company systems and assist the department in day-to-day posting duties.  The Escalation Specialist is also responsible for identifying and keeping the Posting manager up to date with coaching opportunities for Posting specialist based on their findings.

Essential Functions and Tasks

  • Research any missing payment such as EOB’s, check information, or payment information using account information, insurance websites, and contacting insurance if necessary.
  • Resolve all escalated accounts within 24 hours.
  • Extensively investigate whether payments stemming from pt complaints have been posted anywhere in CB outside of the patient’s accounts.
  • Analyzing historical data to identify the root cause of the client/patient escalation.
  • Timely handling of clarifications from overseas team across both legacy and CB systems.
  • Posts Accounts Payable deposits.
  • Processes electronic 835’s and manual payer EOBs, including the posting of insurance allowable, patient portions, denials, adjustments, contractual allowances, recoups, and forward balancing.
  • Interprets Explanation of Benefits (EOB) remittance codes and applies correct denial codes.
  • Balances and closes payment batches timely.
  • Maintain open lines of communication by reporting coaching opportunities directly to Posting Managers as needed by email communications in a detailed, concise, and timely manner.
  • Performs special projects and other duties as assigned.

Education and Experience Requirements

  • High School Diploma or GED
  • At least six (6) years of Cash Posting experience

Knowledge, Skills, and Abilities

  • Professional, accurate, clear, and concise written and verbal communication
  • Attention to detail
  • Positive and encouraging attitude
  • Average QA score of 90% or higher for past 90 days
  • Excellent time and attendance (not on attendance counseling)
  • Not on any form of disciplinary action
  • Ability to exercise sound judgment and handle highly sensitive and confidential information appropriately
  • Ability to remain flexible and work within a collaborative and fast paced environment
  • Ability to communicate with diverse personalities in a tactful, mature, and professional manner
 

Compensation

  • Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. 
  • This position is also eligible for a discretionary incentive bonus in accordance with company policies. 

Ventra Health

Equal Employment Opportunity (Applicable only in the US)
Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.
 
Recruitment Agencies
Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.
 
Solicitation of Payment
Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.

 

Attention Candidates
Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.
To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/. 

 

Statement of Accessibility
Ventra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.

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