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, governmental, and other payers to resolve claim payment issues, to secure appropriate and timely reimbursement and response. Identifies and analyzes denials, payment variances, and no response claims and acts to resolve claims/accounts, including drafting and submitting technical and clinical appeals. Provides support for all denial, no response, and audit activities.
Essential Job Functions
- Examines denied and other non-paid claims to determine reason for discrepancies.
- Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolve payment variances, and ensures timely and accurate reimbursement.
- Ability to identify with specific reason underpayments, 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 takes appropriate action accordingly.
- Documents all activity accurately including contact names, addresses, phone numbers, and other pertinent information in the client’s host system and/or appropriate tracking system.
- 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.
- Must meet productivity and quality standards as established by Ensemble.
Experience:
• 1+ years of customer service experience
Minimum Education:
• High School Diploma/GED Required
Certifications:
• CRCR Required within 6 months of hire (Company Paid)
Expected Knowledge, Skills and Abilities
- Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
- 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.
- Meet quality and productivity standards within timelines set forth in policies.
- Meet required attendance policies.
- 2 or 4-year college degree.
- 1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
- Knowledge of claims review and analysis.
- Working knowledge of revenue cycle.
- Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
- Working knowledge of medical terminology and/or insurance claim terminology.
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
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Innovation
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Work-Life Flexibility
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Leadership
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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.
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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.
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Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
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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 [email protected].
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.
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What We Do
Ensemble Health Partners is a leading innovator in revenue cycle management, helping healthcare providers improve financial outcomes and patient experiences with an unrivaled depth of expertise and best-in-class technologies. Ensemble offers full revenue cycle outsourcing as well as a comprehensive suite of healthcare financial management point solutions. With clients spanning the U.S. and Europe, we have been helping to improve healthcare outcomes for millions of patients while saving hundreds of millions of dollars for healthcare providers. We are committed to bringing every provider that we support to the peak of revenue cycle excellence. Our approach forges true partnerships that dive deep into the details to find solutions and deliver results that last. Recognized with multiple industry awards and as a Becker’s Healthcare Top Workplace, Ensemble is setting a new standard for provider support services - redefining the possible in healthcare by empowering people to be the difference.
