SR A/R Specialist
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference
The Opportunity:
Responsible for following up directly with commercial and governmental payers to resolve claim issues and secure appropriate and timely reimbursement. Identifies and analyzes denials and payment variances and acts to resolve account including drafting and submitting technical appeals.
Essential Functions:
• Examines denied and in process claims to determine reason for resolution.
• Communicates directly with payers to follow up on outstanding claims, file technical appeals, resolve balance variances, and ensure timely reimbursement. • Ability to identify with specific reason denials, and cause of payment delay.
• Works with management to identify, trend, and address root causes of issues in the A/R.
• Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and taken appropriate action accordingly. • Documents activity accurately including contact names, addresses, phone numbers, and other pertinent information.
• Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.
• Needs to be a strong problem solver and critical thinker to resolve accounts.
• Performs other duties as assigned
Requirements:
• High School Diploma or GEDHigh School Diploma or GED with preference for 2 or 4 year degree or 4 years’ direct experience for external candidates.
• Internal candidate must be in revenue cycle for 6 months internally and must have met 100% productivity consistently, 95% Quality Assurance in each of the last 3 months. No disciplinary action in past 6 months, committed to flexible work schedule to meet business needs and additional responsibilities as assigned.
Other Knowledge, Skills and Abilities Required:
• 1-3 years of relevant experience in medical collections or professional billing preferred.
• Knowledge of claims review and analysis.
• Working knowledge of revenue cycle.
• Experience working the DDE Medicare system.
• Working knowledge of medical terminology and/or insurance claim terminology.
• Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
• Must pass typing test of 35 words per minute (error adjusted).
• Excellent Verbal skills.
• Problem solving skills, the ability to look at account and determine a plan of action for collection.
• Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment. • • Adaptability to changing procedures and growing environment.
• Must commit to work overtime, weekend, and open to schedule modification to meet business needs.
Join an award-winning company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
- Innovation
- Work-Life Flexibility
- Leadership
- Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
- Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
- Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
- Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
- Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.