Jobs at Ensemble Health Partners

Reviews complex clinical and technical claim denials, underpayments, medical records, and payer policies; prepares provider, member, IRO, and ALJ appeals; identifies payment trends; coordinates documentation with providers and case management; ensures HIPAA and ERISA compliance; and mentors denial and underpayment team members.

Manage client hospital billing and ensure procedures are billed per contracts; review and update client statements; print and mail paper and secondary claims; scan documents to patient accounts; review correspondence and follow up; maintain regulatory compliance and perform other assigned duties.

Analyzes hospital and physician revenue cycle data to identify underpayments, contractual variances, denials, and delayed payments. Communicates with payors, files appeals, resolves account discrepancies, identifies root causes, and recommends process improvements. Documents activities, reports trends to leadership, collaborates with billing, coding, managed care, revenue integrity, and payor strategy teams, and meets productivity and quality standards in a remote, KPI-driven environment.

The role involves designing and improving workflows in revenue cycle management using AI and automation, focusing on efficiency and effectiveness.

Investigate and recover underpayments on hospital and physician accounts by communicating with payors, filing appeals, identifying root causes, documenting activity in client host systems (Ensemble IQ), and collaborating with client, contract management, and leadership to meet productivity and quality targets.

Manage daily failed bills and claims across systems, resolve electronic submission (277) issues, process late charges and rebills, attach EOBs/medical records, contact payers and patients for billing information, create and deliver training, and support staffing desks. Ensure claim error monitoring and recommend system fixes to improve revenue cycle operations.

Interview uninsured or under-insured patients to determine Medicaid or financial assistance eligibility; assist and follow up on applications, update insurance and billing records, maintain program knowledge, document actions in patient accounting systems, and collaborate with Medicaid caseworkers and revenue cycle teams.

Supervise day-to-day medical coding for acute care or physician facilities: manage staff, monitor productivity and quality, perform audits, support coding education, maintain coding guideline compliance, resolve technical issues, and assist leadership to meet revenue cycle goals.

Interview uninsured/under-insured patients to determine Medicaid or financial assistance eligibility, assist and follow up on applications, update insurance and billing information, document actions in patient accounting systems, maintain knowledge of state/federal program rules, and collaborate with Medicaid caseworkers and revenue cycle teams.

Interview uninsured/under-insured patients to assess eligibility for Medicaid or financial assistance, assist and follow up on applications, update insurance and billing records, document actions in patient accounting systems, maintain knowledge of program requirements, and coordinate with Medicaid caseworkers and revenue cycle teams.

Interview uninsured/under-insured patients to determine Medicaid or financial assistance eligibility, complete and follow up on applications, update insurance/billing records, document actions, and coordinate with Medicaid caseworkers and revenue cycle teams.

Interview uninsured or under-insured patients to determine Medicaid or financial assistance eligibility; assist with and follow up on applications; update insurance and billing information; document all actions in patient accounting systems; maintain knowledge of state and federal program requirements; collaborate with Medicaid caseworkers and revenue cycle teams.

The Lead Technology Engineer will lead IT systems implementation, ensure network security, manage integrations, and enhance operational efficiency through automation.